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Angèle Malâtre-Lansac

2018–19 French Harkness Fellow in Health Care Policy and Practice Associate Director Health Policy Program Institut Montaigne

Angele Malatre Lansac

Placement: RAND Corporation

Mentor: Mark Friedberg (Senior Physician Policy Researcher and Director, RAND Boston)

Co-mentors: Charles Engel (Senior Physician Policy Researcher, RAND Boston)

Richard Frank (Margaret T. Morris Professor of Health Economics, Harvard Medical School)

Project: Barriers and Opportunities to Integrate Behavioral Health in Primary Care

Angèle Malâtre-Lansac, M. Public Affairs, is a 2018–19 French Harkness Fellow in Health Care Policy and Practice. She is currently Associate Director in charge of Health Care Policy at Institut Montaigne, a pioneering independent think tank dedicated to public policy in France and Europe. Within the organization, Malâtre-Lansac created and developed a program dedicated to addressing the major challenges faced in the health sector. Through this program, she brings new ideas and concrete proposals to public authorities and key opinion leaders to improve the quality and performance of the French Health Care system. She is focused on addressing patient needs and adopting a patient-centered approach in her research. Previously, Malâtre-Lansac served as the Deputy Director of Institut Montaigne for a period of two years. During this time, she greatly influenced the organization’s economic model and relationships with its members. She also created and led the Department of Studies for four years, piloting numerous working groups and reports. Malâtre-Lansac has co-authored twenty publications. She holds a Master in Public Affairs from Sciences Po Paris, and completed part of her studies in Great Britain, at Warwick University, and at ITAM in Mexico.

Project Abstract: Epidemiological surveys estimate that 30% of the adult population in the U.S. suffer from one or more mental conditions. However, poor quality of care and stigma are common, and there is a significant gap between the prevalence of mental illnesses and the number of people receiving treatment for their condition. In response to these critical needs, the integration of behavioral health in primary care has been proven to enhance access to care, reduce stigma, and improve quality at lower cost.

Despite the evidence that exits for Behavioral Health Integration (BHI), and particularly for the Collaborative Care Model, this model is not prevalent in the U.S. Missing from the overall literature is a better understanding of what could be done to disseminate high quality Behavioral Health Integration, and a description of what barriers physician practices have encountered in implementing the model, how they overcame these barriers, and what lessons can be learned from more than two decades of Behavioral Health Integration.

This initial phase of the study will be based on data collection from the existing literature and interviews with experts in the field. The second phase will be based on interviews with physicians, nursing staff, care managers, patients and mental health providers from a purposive sample of approximately 30 practices across the US. Care delivery, organization, workflow, infrastructure and payment models will be emphasized, and the most promising strategies identified will be analyzed to provide recommendations for policymakers in the U.S. and France.

Harkness-Related Publications:

A. Malâtre-Lansac, C. Engel, L. Xenakis, L. Carlasare, K. Blake, C. Vargo, C. Botts, P. Chen, M. Friedberg. Factors Influencing Physician Practices' Adoption of Behavioral Health Integration in the United States - A Qualitative Study. Annals of Internal Medicine. 2020. 

A. Malâtre-Lansac. An International Perspective On The Paradoxes Of US Health Care. Health Affairs. 2019.