{"doi":"10.1007/s11606-024-09264-x","title":"Prevalence of Behavioral Health Conditions in a Safety-Net General Internal Medicine Practice","abstract":"All analyses used de-identified data from patients 18 and older who visited the general internal medicine clinic at a safety-net health system in Minneapolis, MN, from January 1, 2021, to December 31, 2023. We compared patients with the most common behavioral health conditions, which included anxiety disorders, depressive disorders, alcohol use disorder, opioid use disorder, and/or stimulant use disorder to patients without these diagnoses. This combination of conditions was chosen because the clinic offers evidence-based medications for these conditions. Conditions were defined using International Classification of Diseases, Tenth Revision, Clinical Modification codes: F.32* (depressive disorders), F.41* (anxiety disorders), F.11* (opioid use disorders), F.10* (alcohol use disorders), F14* (cocaine use disorders), and F.15* (other stimulant use disorders). Among patients with behavioral health conditions, we compared demographic characteristics among people who were diagnosed with anxiety disorders and/or depressive disorders only (AD/DD), substance use disorder (SUD) only, or both (AD/DD) and SUD. We compared demographic characteristics across groups with chi-squared tests. We used a de-identified dataset; therefore, our study was determined to not be human subjects research by the Hennepin Healthcare Research Institute Institutional Review Board. Our sample consisted of 72,499 patients ages 18 and older with at least one visit to a general internal medicine clinic over a 3-year period. Of these patients, 38.6% were diagnosed with at least one behavioral health condition, which suggests a substantial opportunity for integrated treatment in the safety-net primary care setting (Table 1 ). In particular, more than half of patients who identified as American Indian/Alaska Native (AI/AN), non-Hispanic White, or had one of the reported physical health conditions had a behavioral health condition. Patients who spoke a language other than English had a lower prevalence of behavioral health conditions compared to patients who spoke English. Among patients with behavioral health conditions, the proportion of patients with AD/DD only was 58.1%, SUD only was 13.7%, and co-occurring AD/DD and SUD was 28.2% (Table 2 ). Specifically, substance use was more common among male patients and patients with chronic physical health conditions. Types of behavioral health conditions had substantial variation across demographic groups. Notably, over half of patients who identified as AI/AN were diagnosed with both AD/DD and SUD. Within a general internal medicine clinic in a Midwestern safety-net health system, nearly two in five patients were diagnosed with a behavioral health condition. Patients who identified as AI/AN or White or were diagnosed with a chronic physical health condition had a particularly high prevalence of behavioral health conditions. These estimates highlight that safety-net clinics are an important front door for patients needing behavioral health treatment. The high prevalence of substance use disorders and co-occurring disorders among patients who identified as Black or AI/AN also highlights the need for culturally specific approaches to treatment. Models that integrate behavioral health services into primary care, like the Collaborative Care Model, could improve the sustainability of primary care practices that serve patients with a high burden of behavioral and physical health conditions. The future of primary care and behavioral health care in the USA are intertwined and reforms that target both should be prioritized.","journal":"Journal of General Internal Medicine","year":2024,"id":482612,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":1,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.6233,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2024-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":386365,"name":"Becky R. Ford","orcid":null,"position":1,"is_corresponding":false},{"id":385061,"name":"Tyler N. A. Winkelman","orcid":"0000-0002-9581-5223","position":2,"is_corresponding":false},{"id":562764,"name":"Roberto Lopez Cervera","orcid":"0000-0001-6584-486X","position":0,"is_corresponding":true}],"reference_count":5,"raw_metadata":null,"created_at":"2026-07-19T02:07:18.280369Z","pmid":"39668314","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}