Integrating behavioral health into pulmonary medicine: a call to action

There is a strong need for integrated behavioral health (IBH) services in clinics that serve patients with chronic illness who experience high co-occurring mental and physical health burdens. However, the specific needs of patients with pulmonary diseases and sleep disorders, whose mental and physical health are significantly affected by these conditions, are not well characterized. We conducted a needs assessment in an outpatient practice serving patients with pulmonary diseases and/or sleep disorders, that recently began providing IBH services. Our goal was to broadly characterize the physical and mental health needs of these patients, as well as explore differences by medical condition, sex, and level of functioning. Among the 260 patients who participated in our online survey (51% female, 77% age 51 or older), 38% had sleep disorders, 26% airway diseases, 6% interstitial lung diseases/diffuse parenchymal lung diseases, 6% pulmonary vascular diseases, and 24% other pulmonary diseases (e.g., lung cancer). Patients with airway diseases and patients with sleep disorders emerged as two groups with significant physical and mental health burdens based on ANOVAs. T-tests showed that female patients reported worse mental and physical health functioning compared to male patients. ANOVAs also showed that patients with limited physical ability had lower physical, mental, and pulmonary health functioning, as well as greater patient care needs, compared to patients who were symptom-free. Findings highlight the potential need for and promise of integrating behavioral health services within clinics serving patients with pulmonary and sleep conditions. Our needs assessment shows how pulmonary disease and sleep disorder patients bear a significant burden of physical and mental health-related needs, and how specific concerns relate to their particular condition, sex, and functional status.