Residents living in US-Mexico border communities have some of the worst health outcomes nationally. Rates of chronic disease such as obesity, diabetes, and related mortality in the Rio Grande Valley exceed those in most other regions of Texas and the nation. Poverty is pervasive, placing residents at high risk for poor health; they are more likely to be exposed to environmental hazards and have higher rates of chronic physical and mental health concerns.

At its foundation, integrated behavioral health care aims to address multiple health concerns, and related social determinants, by bringing behavioral health and primary care services together. No single model of integrated behavioral health care can be applied universally to health or social service settings; however, each approach is team-based and involves collaboration between multidisciplinary health and social service providers to achieve shared patient and community outcomes.

This randomized trial evaluated whether patients receiving enhanced integrated behavioral health care at a southern Texas free and charitable were more likely to improve health outcomes after 12 months compared to patients receiving standard care.