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The use of medical services is a function of several interacting psychological and social variables as well as a function of physical malfunction. The clinical significance of addressing patients’ psychosocial issues has only occasionally been considered. However, the shift in health care economics toward health care maintenance is responsible for the increased interest in interventions in the domain of behavioral medicine and health psychology. Evidence is reviewed for 6 mechanistic pathways by which behavioral interventions can maximize clinical care and result in significant economic benefits. The rationale for further integration of behavioral and biomedicine interventions is also reviewed.

The current health care reform agenda represents both a threat and an opportunity for mental health providers and behavioral scientists. The health care system is reeling under the impact of escalating costs, limited access, and the prospect of an aging population with multiple chronic illnesses that will increase demand for health care. Traditionally, the primary focus of most mental health providers has been on the diagnosis and treatment of mental illness—an important and challenging undertaking in itself. However, the current health care debate challenges health care providers to look beyond diagnostic categories and disciplinary boundaries, beyond the dysfunctional distinction between mind and body, and beyond traditional psychotherapeutic interventions. The challenge is to most effectively address the true needs that people bring into the health care system and to do so with maximum efficiency.

Increasingly, the focus of health care reform is controlling costs, and the secondary focus is on improving health and quality outcomes. Although studies have shown that providing psychological services can reduce health care costs (Pallak, Cummings, Dorken, & Henke, 1995), the national health care reform agenda, driven by a concern for cost containment, ensures that medical services in general and mental health services in particular will be examined in...