the situation provides a new opportunity for behavioral health care professionals to
become part of the solution to the health care crisis through the skills and training they
have to offer to primary care providers. But the fact is that behavioral health care pro-
fessionals have been providing these types of services for decades; it is the recognition
of their value and the need to offer them through formalized programs that are recent
advances. And it is this recognition that has served as the impetus for this handbook.

Several approaches could have been taken to develop a volume that would be use-
ful to behavioral health practitioners who either are currently providing services in
primary care settings or are considering such an undertaking. For example, the focus
could have been on developing and implementing an integrated primary and behav-
ioral health care program from the ground up; on providing brief, symptom-oriented
therapies in primary care settings; or on describing models of consultation with pri-
mary care providers. Here, it is on using psychological screening and assessment in-
struments in primary care settings. My own experience lies in assessment, and I
believe one of the most significant contributions behavioral health care can make to the
more effective solution of mental health and substance abuse problems (and concomi-
tant costs) in primary care settings is the tools and expertise it brings to the tasks of
identifying and monitoring these problems.

There is a large audience for the type of information presented in this handbook
which can be used not only by behavioral health care professionals, but also by pri-
mary care providers who may want to integrate into their practices the instruments
(with additional, supervised training, as necessary) and/or other information dis-
cussed in the chapters that follow.

To facilitate readers' understanding, I have organized the book into four parts. Part I
contains five chapters that deal with general topics and issues that provide a context
for the information presented in the subsequent chapters. Chapter 1 discusses the
prevalence of behavioral health disorders in primary care settings, their direct and in-
direct costs, and the concomitant need for better identification and treatment of mental
health and substance use by primary care providers. Integrated primary and behav-
ioral health care is identified as a solution to the existing problems--a solution that
may take any of several forms, depending on the particular needs of the individual pri-
mary care setting. Chapter 1 also provides an overview of the potential contributions
of various types of psychological assessment instruments for screening patients, plan-
ning an appropriate course of treatment, and assessing the outcomes of that treatment.
The remaining four chapters in Part I address important issues and considerations re-
lated to the integration of primary and behavioral health care in general, with special
attention being given to the integration of psychological assessment.

Part II presents a detailed discussion of each of a number of psychological instru-
ments that I feel are useful for screening and/ or monitoring primary care patients with
significant behavioral health problems. The instruments considered as potential chap-
ter topics were evaluated against several selection criteria, including the popularity of
the instrument among behavioral health clinicians; recognition of its psychometric in-
tegrity; in the case of recently released instruments, the potential for the instrument to
become widely accepted and used; the perceived usefulness of the instrument for
screening and monitoring purposes; and the availability of a recognized expert on the
instrument (preferably its author) to contribute a chapter to this book. In the end, the
instrument-specific chapters selected for inclusion were those judged most likely to be
of the greatest interest and utility to the majority of the book's intended audience.

The first three chapters of Part II deal with instruments developed specifically for
use in primary care settings. These are the PRIME-MD, the COMPASS-PC, and the
Shedler QPD Panel. Each of these multiscale instruments can be used to screen for the

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