What Is the Collaborative Care Model? How It Works and What LifeStance Data Shows

Primary care physicians (PCPs) are often the first, and sometimes only, point of contact for patients experiencing anxiety, depression, and other behavioral health conditions. Yet when a patient needs specialized support, many PCPs struggle to connect them to care.

Even with well-designed referral programs, 30-50% of referred patients never make it to their first behavioral health appointment. That gap often leaves patients without the care they need, contributing to lower quality of life and higher health care costs.

Rather than referring patients out, integrated behavioral health (IBH) brings behavioral health care into primary care. The most widely studied IBH model is the Collaborative Care Model (CoCM).

Here’s what it is, how it works, and what the data shows when it’s put into practice.

What Is the Collaborative Care Model (CoCM)?

CoCM is a team-based approach to managing common mental health conditions that present in primary care. The CoCM team consists of the PCP, a licensed therapist embedded directly within the primary care practice, a psychiatric consultant who provides medication and treatment recommendations to the therapist and PCP, and the patient. All team members work together to help the patient reach their treatment goals. Patients can schedule a behavioral health visit at checkout, sometimes as soon as the same day, and receive care in a setting they already know and trust. The model is intentionally designed to reduce barriers that often derail traditional referrals, like long wait times, scheduling friction, and stigma. 

All CoCM team members work together to create a treatment plan and track patient progress with clinically validated tools: the Patient Health Questionnaire-9 (PHQ-9) for depression and the Generalized Anxiety Disorder-7 (GAD-7) for anxiety. This measurement-informed approach helps ensure progress is visible, and that care can be adjusted when needed.

LifeStance Health is a national leader in mental, behavioral, and emotional wellness with multiple locations in 33 states. Services vary by location.

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What the Data Shows About a Collaborative Care Model

LifeStance Health partnered with a large primary care medical group to implement two parallel approaches to improving access to behavioral health care: a coordinated referral pathway and an IBH program using CoCM.

As part of LifeStance’s CoCM program, a LifeStance licensed mental health clinician was embedded on-site with a dedicated schedule, enabling immediate and seamless appointment booking. Additionally, where available, patients were able to meet the clinician in-office prior to making an appointment to help eliminate any hesitation about attending their first visit.

Over a one-year period, patients enrolled in CoCM were more than twice as likely to attend their initial behavioral health visit:

  • 78% of patients enrolled in CoCM attended their first behavioral health appointment, compared to 38% of patients referred through the coordinated referral pathway.

For a deeper look at the findings, read the LifeStance white paper published in Becker’s Healthcare.

Bringing the Collaborative Care Model to Your Health System

When behavioral health care is integrated into primary care, more individuals are likely to engage and experience meaningful improvement. CoCM offers a scalable, evidence‑based approach that meets people where they already receive care.

LifeStance offers turnkey CoCM services to health systems looking to close the gap between referral and treatment.

Partner with LifeStance to bring CoCM to your health system

References

  1. Archer, J., Bower, P., Gilbody, S., Lovell, K., Richards, D., Gask, L., Dickens, C., & Coventry, P. (2012). Collaborative care for depression and anxiety problems. Cochrane Database of Systematic Reviews, (10), Article CD006525. https://doi.org/10.1002/14651858.CD006525.pub2

  2. Becker’s Hospital Review. (n.d.). A more effective path to behavioral health access starts in primary care. https://go.beckershospitalreview.com/behavioralwp/a-more-effective-path-to-behavioral-health-access-starts-in-primary-care

  3. Collins, B., Downing, J., Head, A., Cornerford, T., Nathan, R., & Barr, B. (2023). Investigating the impact of undiagnosed anxiety and depression on health and social care costs and quality of life: Cross-sectional study using household health survey data. BJPsych Open, 9(6), e201. https://doi.org/10.1192/bjo.2023.596

  4. Fisher, L., & Ransom, D. C. (1997). Developing a strategy for managing behavioral health care within the context of primary care. Archives of Family Medicine, 6(4), 324–333. https://doi.org/10.1001/archfami.6.4.324

  5. Taylor, H. L., Menachemi, N., Gilbert, A., et al. (2023). Economic burden associated with untreated mental illness in Indiana. JAMA Health Forum, 4(10), e233535. https://doi.org/10.1001/jamahealthforum.2023.3535

  6. Unützer, J., Carlo, A. C., Arao, R., Vredevoogd, M., Fortney, J., Powers, D., & Russo, J. (2020). Variation in the effectiveness of collaborative care for depression: Does it matter where you get your care? Health Affairs, 39(11), 1943–1950. https://doi.org/10.1377/hlthaff.2019.01714

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Authored By 

Kristin MacGregor, PhD, LP

Dr. Kristin MacGregor is a licensed clinical health psychologist and serves as the National Clinical Director for Integrated Behavioral Health (IBH). In this role, she leads efforts to advance whole-person care by partnering with health systems to build out their...

Reviewed By

Angela Caiazza, MS, LMFT
Angela M. Caiazza is a Licensed Marriage and Family Therapy in Oregon who started practicing in 2010. She has a Pastoral Theology certification from Berean Institute and a BA in Psychology and an MS in Counseling from the University of Nevada Las Vegas. Angela believes in an eclectic approach depending on specific and unique circumstances of each client. The majority of her work tends to utilize the Gottman method, Emotionally Focused Therapy, Cognitive Behavioral interventions, and Eye Movement Desensitization Reprocessing (EMDR) as well as other systemic frameworks which include developmental experiences and interactions within relationships. In her spare time, Angela enjoys writing, nature, fitness, drums, and Harley Davidsons.

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