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This paper examines the promises and pitfalls of integrated models of mental health care in primary care settings, and presents the findings of a successful pilot study of integrated care. There are a number of technological breakthroughs which could improve treatment outcomes. However, research indicates improved outcomes are likely only when changes include new practice patterns, patient education, and systematic monitoring of patient process and outcomes. A study in a health maintenance organization is presented based on a staged model of treatment and exemplifying these principles. We conclude that integrated models while technically feasible, are organizationally complex in actual practice.