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Primary care mental health integration

Marie-Josée Fleury, Guy Grenier, Catherine Vallée, Denise Aubé, Lambert Farand, Jean-Marie Bamvita, Geneviève Cyr
BACKGROUND: This study evaluates implementation of the Quebec Mental Health (MH) Reform (2005-2015) which aimed to improve accessibility, quality and continuity of care by developing primary care and optimizing integrated service networks. Implementation of MH primary care teams, clinical strategies for consolidating primary care, integration strategies to improve collaboration between primary care and specialized services, and facilitators and barriers related to these measures were examined...
October 18, 2016: BMC Health Services Research
Jennifer M Hensel, Jay Shaw, Lianne Jeffs, Noah M Ivers, Laura Desveaux, Ashley Cohen, Payal Agarwal, Walter P Wodchis, Joshua Tepper, Darren Larsen, Anita McGahan, Peter Cram, Geetha Mukerji, Muhammad Mamdani, Rebecca Yang, Ivy Wong, Nike Onabajo, Trevor Jamieson, R Sacha Bhatia
BACKGROUND: Mental illness is a substantial and rising contributor to the global burden of disease. Access to and utilization of mental health care, however, is limited by structural barriers such as specialist availability, time, out-of-pocket costs, and attitudinal barriers including stigma. Innovative solutions like virtual care are rapidly entering the health care domain. The advancement and adoption of virtual care for mental health, however, often occurs in the absence of rigorous evaluation and adequate planning for sustainability and spread...
October 18, 2016: BMC Psychiatry
Soteri Polydorou, Stephen Ross, Peter Coleman, Laura Duncan, Nichole Roxas, Anil Thomas, Sonia Mendoza, Helena Hansen
OBJECTIVES: This report identifies the institutional barriers to, and benefits of, buprenorphine maintenance treatment (BMT) integration in an established hospital-based opioid treatment program (OTP). METHODS: This case study presents the authors' experiences at the clinic, hospital, and corporation levels during efforts to integrate BMT into a hospital-based OTP in New York City and a descriptive quantitative analysis of the characteristics of hospital outpatients treated with buprenorphine from 2006 to 2013 (N=735)...
October 17, 2016: Psychiatric Services: a Journal of the American Psychiatric Association
Rodger S Kessler, Andrea Auxier, Juvena R Hitt, C R Macchi, Daniel Mullin, Constance van Eeghen, Benjamin Littenberg
Introduction: We developed the Practice Integration Profile (PIP) to measure the degree of behavioral health integration in clinical practices with a focus on primary care (PC). Its 30 items, completed by providers, managers, and staff, provide an overall score and 6 domain scores derived from the Lexicon of Collaborative Care. We describe its history and psychometric properties. Method: The PIP was tested in a convenience sample of practices. Linear regression compared scores across integration exemplars, PC with behavioral services, PC without behavioral services, and community mental health centers without PC...
October 13, 2016: Families, Systems & Health: the Journal of Collaborative Family Healthcare
Preety Das, Chris Naylor, Azeem Majeed
No abstract text is available yet for this article.
October 2016: Journal of the Royal Society of Medicine
Justin W L Keogh, Tim Henwood, Paul Gardiner, Anthony Tuckett, Brent Hodgkinson, Kevin Rouse
Progressive resistance plus balance training (PRBT) has been demonstrated as effective in reducing later life physical disability, falls risk and poor health, even among those with complex health care needs. However, few studies have examined the influence of PRBT on health service utilisation, cognitive wellbeing and training modality acceptance or undertaken a cost benefit analysis. This project will investigate the broad scope benefits of PRBT participation among community-dwelling older Australians receiving Government supported aged care packages for their complex health care needs...
October 6, 2016: Archives of Gerontology and Geriatrics
Elena Longhi, Lynne Murray, Rachael Hunter, David Wellsted, Samantha Taylor-Colls, Kathryn MacKenzie, Gwynne Rayns, Richard Cotmore, Peter Fonagy, Richard M Pasco Fearon
BACKGROUND: Young mothers living in low-income urban settings often are exposed to significant and chronic environmental difficulties including poverty, social isolation and poor education and typically also have to cope with personal histories of abuse and depression. Minding the Baby® (MTB) is an interdisciplinary home-visiting programme developed to support first-time young mothers, which integrates primary care and mental health approaches into a single intensive intervention from the last trimester of pregnancy until the child's second birthday...
October 7, 2016: Trials
Karen Athié, Alice Lopes do Amaral Menezes, Angela Machado da Silva, Monica Campos, Pedro Gabriel Delgado, Sandra Fortes, Christopher Dowrick
BACKGROUND: Community-based primary mental health care is recommended in low and middle-income countries. The Brazilian Health System has been restructuring primary care by expanding its Family Health Strategy. Due to mental health problems, psychosocial vulnerability and accessibility, Matrix Support teams are being set up to broaden the professional scope of primary care. This paper aims to analyse the perceptions of health professionals and managers about the integration of primary care and mental health...
September 30, 2016: BMC Health Services Research
Malcolm B Doupe, Suzanne Day, Wes Palatnick, Alecs Chochinov, Dan Chateau, Carolyn Snider, Ricardo Lobato de Faria, Erin Weldon, Shelley Derksen
BACKGROUND: Scientists have called for strategies to identify ED patients with unmet needs. We identify the unique profile of ED patients who arrive by ambulance and subsequently leave without consulting a provider (ie, a paradoxical visit, PV). METHODS: Using a retrospective cohort design, administrative data from Winnipeg, Manitoba were interrogated to identify all ED patients 17+ years old as having zero, single or multiple PVs in 2012/2013. Analyses compare the sociodemographic, physical (eg, arthritis), mental (eg, substance abuse) and concurrent healthcare use profile of non-PV, single and multiple PV patients...
October 4, 2016: Emergency Medicine Journal: EMJ
Heidi M Crane, Rob J Fredericksen, Anna Church, Anna Harrington, Paul Ciechanowski, Jennifer Magnani, Kari Nasby, Tyler Brown, Shireesha Dhanireddy, Robert D Harrington, William B Lober, Jane Simoni, Stevan A Safren, Todd C Edwards, Donald L Patrick, Michael S Saag, Paul K Crane, Mari M Kitahata
BACKGROUND: Adherence to antiretroviral medications is a key determinant of clinical outcomes. Many adherence intervention trials investigated the effects of time-intensive or costly interventions that are not feasible in most clinical care settings. OBJECTIVE: We set out to evaluate a collaborative care approach as a feasible intervention applicable to patients in clinical care including those with mental illness and/or substance use issues. METHODS: We developed a randomized controlled trial (RCT) investigating an integrated, clinic-based care management approach to improve clinical outcomes that could be integrated into the clinical care setting...
October 5, 2016: JMIR Research Protocols
Teri D Davis, Duncan G Campbell, Laura M Bonner, Cory R Bolkan, Andrew Lanto, Edmund F Chaney, Thomas Waltz, Kara Zivin, Elizabeth M Yano, Lisa V Rubenstein
OBJECTIVE: Depression is the most prevalent mental health condition in primary care (PC). Yet as the Veterans Health Administration increases resources for PC/mental health integration, including integrated care for women, there is little detailed information about depression care needs, preferences, comorbidity, and access patterns among women veterans with depression followed in PC. METHODS: We sampled patients regularly engaged with Veterans Health Administration PC...
September 30, 2016: Women's Health Issues: Official Publication of the Jacobs Institute of Women's Health
Joseph A Boscarino, H Lester Kirchner, James M Pitcavage, Vijay R Nadipelli, Naoko A Ronquest, Michael H Fitzpatrick, John J Han
OBJECTIVE: Opioid overdoses (ODs) have been increasing, and harm reduction efforts are a priority. The success of these efforts will be dependent on the identification of at-risk patients and improved access to the antidote naloxone. Therefore, to identify access to naloxone and factors associated with negative health outcomes, we conducted a retrospective study of patients with OD to identify those at highest risk of adverse outcomes and to assess the use of naloxone. METHODS: We conducted a study of electronic health records for patients admitted to the largest multihospital system in the region - the Geisinger Health System (GHS) for ODs - from April 2005 through March 2015...
2016: Substance Abuse and Rehabilitation
Lisa Zubkoff, Brian Shiner, Bradley V Watts
INTRODUCTION: Guidelines recommend that substance use disorder (SUD) treatment be available in primary care-mental health integrated clinics, which offer mental and behavioral health assessment and treatment in the primary care setting. Despite this recommendation it is unclear what barriers and facilitators exist to SUD treatment being provided in that setting. This work sought to understand current SUD services in such integrated clinics, explore other services may that be appropriate, and identify barriers to such services...
November 2016: Journal of Substance Abuse Treatment
Ali Montazeri, Sahand Riazi-Isfahani, Behzad Damari
BACKGROUND: Social issues have prominent effects on the peoples' physical and mental health and on the health risk factors. In Iran, many organizations provide social care services to their target population. This study aimed to explore the roles and functions of Primary Health Care (PHC) system in providing social care services in Iran. METHODS: This was a qualitative study, for which data were collected via three sources: A review of the literature, in-depth interviews and focus group discussions with experts and stakeholders...
2016: Medical Journal of the Islamic Republic of Iran
Antonella Piazza, Paola Rucci, Massimo Clo, Dino Gibertoni, Lucia Camellini, Marinella Di Stani, Maria Pia Fantini, Mila Ferri, Angelo Fioritti
PURPOSE: To estimate the treated prevalence of eating disorders (ED) in Emilia-Romagna, Italy, and to compare health services utilization among age groups and geographical areas. METHODS: The study cohort consists of patients aged 12-64 years with a primary or secondary ED diagnosis, treated in regional healthcare facilities in 2012. Patients were followed up for 1 year from the first contact. Data were extracted from regional administrative databases. RESULTS: The study cohort included 1550 cases, 36...
September 29, 2016: Eating and Weight Disorders: EWD
Arthur R Andrews, Debbie Gomez, Austin Larey, Hayden Pacl, Dennis Burchette, Juventino Hernandez Rodriguez, Freddie A Pastrana, Ana J Bridges
Introduction: Type 2 diabetes is often comorbid with internalizing mental health disorders and associated with greater psychiatric treatment resistance. Integrating psychotherapy into primary care can help treat internalizing disorders generally. We explored whether such treatment had comparable effectiveness in patients with and without Type 2 diabetes. Method: Participants were 468 consecutive adults (23% male; 62% Hispanic, Mage = 41.46 years) referred by medical staff for psychotherapy appointments to address internalizing symptoms (e...
September 26, 2016: Families, Systems & Health: the Journal of Collaborative Family Healthcare
Hanna M van Dijk, Jane M Cramm, Erwin Birnie, Anna P Nieboer
BACKGROUND: Integrated neighborhood approaches (INAs) are increasingly advocated to reinforce formal and informal community networks and support community-dwelling older people. They aim to augment older people's self-management abilities and engage informal networks before seeking professional support. INAs' effectiveness however remains unknown. We evaluated an INA's effects on older people's (health-related) quality of life (HRQoL) and well-being in Rotterdam. METHODS: We used a matched quasi-experimental design comparing INA with "usual" care and support...
2016: BMC Research Notes
Maria W Mauritz, Betsie G I Van Gaal, Ruud A Jongedijk, Lisette Schoonhoven, Maria W G Nijhuis-van der Sanden, Peter J J Goossens
BACKGROUND: In the Netherlands, most patients with severe mental illness (SMI) receive flexible assertive community treatment (FACT) provided by multidisciplinary community mental health teams. SMI patients with comorbid posttraumatic stress disorder (PTSD) are sometimes offered evidence-based trauma-focused treatment like eye movement desensitization reprocessing or prolonged exposure. There is a large amount of evidence for the effectiveness of narrative exposure therapy (NET) within various vulnerable patient groups with repeated interpersonal trauma...
2016: European Journal of Psychotraumatology
Bibhav Acharya, Jasmine Tenpa, Poshan Thapa, Bikash Gauchan, David Citrin, Maria Ekstrand
BACKGROUND: Globally, access to mental healthcare is often lacking in rural, low-resource settings. Mental healthcare services integration in primary care settings is a key intervention to address this gap. A common strategy includes embedding mental healthcare workers on-site, and receiving consultation from an off-site psychiatrist. Primary care provider perspectives are important for successful program implementation. METHODS: We conducted three focus groups with all 24 primary care providers at a district-level hospital in rural Nepal...
2016: BMC Health Services Research
Benjamin G Druss, Silke A von Esenwein, Gretl E Glick, Emily Deubler, Cathy Lally, Martha C Ward, Kimberly J Rask
OBJECTIVE: Behavioral health homes provide primary care health services to patients with serious mental illness treated in community mental health settings. The objective of this study was to compare quality and outcomes of care between an integrated behavioral health home and usual care. METHOD: The study was a randomized trial of a behavioral health home developed as a partnership between a community mental health center and a Federally Qualified Health Center...
September 15, 2016: American Journal of Psychiatry
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