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Primary care mental health integration

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https://www.readbyqxmd.com/read/28642211/the-integrating-depression-and-diabetes-treatment-independent-study-design-and-methods-to-address-mental-healthcare-gaps-in-india
#1
A J Kowalski, S Poongothai, L Chwastiak, M Hutcheson, N Tandon, R Khadgawat, G R Sridhar, S R Aravind, B Sosale, R M Anjana, D Rao, R Sagar, N Mehta, K M V Narayan, J Unutzer, W Katon, V Mohan, M K Ali
INTRODUCTION: Depression and diabetes are highly prevalent worldwide and often co-exist, worsening outcomes for each condition. Barriers to diagnosis and treatment are exacerbated in low and middle-income countries with limited health infrastructure and access to mental health treatment. The INtegrating DEPrEssioN and Diabetes treatmENT (INDEPENDENT) study tests the sustained effectiveness and cost-effectiveness of a multi-component care model for individuals with poorly-controlled diabetes and depression in diabetes clinics in India...
June 19, 2017: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/28639389/implementing-two-nurse-practitioner-models-of-service-at-an-australian-male-prison-a-quality-assurance-study
#2
Ides Wong, Eryn Wright, Damian Santomauro, Raquel How, Christopher Leary, Meredith Harris
AIMS AND OBJECTIVES: To examine the quality and safety of nurse practitioner services of two newly implemented nurse practitioner models of care at a correctional facility. BACKGROUND: Nurse practitioners could help to meet the physical and mental health needs of Australia's growing prison population; however, the nurse practitioner role has not previously been evaluated in this context. DESIGN: A quality assurance study conducted in an Australian prison where a primary health nurse practitioner and a mental health nurse practitioner were incorporated into an existing primary healthcare service...
June 21, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28637449/task-shifting-interpersonal-counseling-for-depression-a-pragmatic-randomized-controlled-trial-in-primary-care
#3
Camila T Matsuzaka, Milton Wainberg, Andrea Norcini Pala, Elis V Hoffmann, Bruno M Coimbra, Rosaly F Braga, Annika C Sweetland, Marcelo F Mello
BACKGROUND: Task shifting approaches (rational redistribution of tasks among health workforce teams) to train lay professionals to assist with integrating mental health treatment in primary care has been recommended to close the mental health treatment gap for depression in low- and middle-income countries. This study aims to examine the a new model for depression care in a low-resource environment compared to enhanced treatment at usual (E-TAU). METHODS: We trained non-specialist community health workers (local lay employees of the public health system) to provide Interpersonal Counseling (IPC) to treat depressive symptoms in the Brazilian, São Paulo city, family health strategy (FHS)...
June 21, 2017: BMC Psychiatry
https://www.readbyqxmd.com/read/28634906/delivery-of-brief-cognitive-behavioral-therapy-for-medically-ill-patients-in-primary-care-a-pragmatic-randomized-clinical-trial
#4
Jeffrey A Cully, Melinda A Stanley, Nancy J Petersen, Natalie E Hundt, Michael R Kauth, Aanand D Naik, Kristen Sorocco, Shubhada Sansgiry, Darrell Zeno, Mark E Kunik
BACKGROUND: Few studies have examined the practical effectiveness and implementation potential of brief psychotherapies that integrate mental and physical health. OBJECTIVE: To determine whether an integrated brief cognitive behavioral therapy (bCBT), delivered by mental health providers in primary care, would improve depression, anxiety and quality of life for medically ill veterans. DESIGN: Pragmatic patient-randomized trial comparing bCBT to enhanced usual care (EUC)...
June 20, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28629360/conceptualisation-of-job-related-wellbeing-stress-and-burnout-among-healthcare-workers-in-rural-ethiopia-a-qualitative-study
#5
Medhin Selamu, Graham Thornicroft, Abebaw Fekadu, Charlotte Hanlon
BACKGROUND: Wellbeing of healthcare workers is important for the effective functioning of health systems. The aim of this study was to explore the conceptualisations of wellbeing, stress and burnout among healthcare workers in primary healthcare settings in rural Ethiopia in order to inform the development of contextually appropriate interventions. METHODS: A qualitative study was conducted in a rural zone of southern Ethiopia. A total of 52 frontline primary healthcare workers participated in in-depth interviews (n = 18) or Focus Group Discussions (FGDs) (4 groups, total n = 34)...
June 19, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28622823/does-behavioral-health-integration-improve-primary-care-providers-perceptions-of-health-care-system-functioning-and-their-own-knowledge
#6
Leah Zallman, Robert Joseph, Colleen O'Brien, Emily Benedetto, Ellie Grossman, Lisa Arsenault, Assaad Sayah
OBJECTIVE: To examine the impact of behavioral health integration (BHI) on primary care providers' (PCPs') (1) perceptions of behavioral health (BH)-primary care (PC) system functioning and (2) perceptions of their own knowledge regarding how to manage, triage, and access help in caring for patients with mental health conditions and substance use disorders. METHODS: We implemented BHI based on evidence-based models consisting of seven elements: (1)Screening for mental health and substance use disorders, (2)Training of PC teams, (3)Integration of BH providers into PC teams, (4)Roll-out of unlicensed mental health care managers and establishment of a BH registry, (5)Psychiatry consult service, (6)Site-based BHI meetings, and (7)Site self assessments...
May 2017: General Hospital Psychiatry
https://www.readbyqxmd.com/read/28619114/reducing-the-rate-and-duration-of-re-admissions-among-patients-with-unipolar-disorder-and-bipolar-disorder-using-smartphone-based-monitoring-and-treatment-the-radmis-trials-study-protocol-for-two-randomized-controlled-trials
#7
Maria Faurholt-Jepsen, Mads Frost, Klaus Martiny, Nanna Tuxen, Nicole Rosenberg, Jonas Busk, Ole Winther, Jakob Eyvind Bardram, Lars Vedel Kessing
BACKGROUND: Unipolar and bipolar disorder combined account for nearly half of all morbidity and mortality due to mental and substance use disorders, and burden society with the highest health care costs of all psychiatric and neurological disorders. Among these, costs due to psychiatric hospitalization are a major burden. Smartphones comprise an innovative and unique platform for the monitoring and treatment of depression and mania. No prior trial has investigated whether the use of a smartphone-based system can prevent re-admission among patients discharged from hospital...
June 15, 2017: Trials
https://www.readbyqxmd.com/read/28617021/development-and-implementation-of-a-psychotherapy-tracking-database-in-primary-care
#8
Julia R Craner, Craig N Sawchuk, John D Mack, Michelle A LeRoy
INTRODUCTION: Although there is a rapid increase in the integration of behavioral health services in primary care, few studies have evaluated the effectiveness of these services in real-world clinical settings, in part due to the difficulty of translating traditional mental health research designs to this setting. Accordingly, innovative approaches are needed to fit the unique challenges of conducting research in primary care. The development and implementation of one such approach is described in this article...
June 2017: Families, Systems & Health: the Journal of Collaborative Family Healthcare
https://www.readbyqxmd.com/read/28617020/need-access-and-the-reach-of-integrated-care-a-typology-of-patients
#9
Ana J Bridges, Bianca T Villalobos, Elizabeth A Anastasia, Aubrey R Dueweke, Samantha J Gregus, Timothy A Cavell
INTRODUCTION: This paper is a report on a study exploring a potential typology of primary care patients referred for integrated behavioral health care (IBHC) services. We considered whether primary care patients could be grouped into meaningful clusters based on perceived need for behavioral health services, barriers to accessing care, and past-year service utilization. We also described the development of a working partnership between our university-based research team and a federally qualified health center (FQHC)...
June 2017: Families, Systems & Health: the Journal of Collaborative Family Healthcare
https://www.readbyqxmd.com/read/28614167/the-role-of-organizational-context-in-the-implementation-of-a-statewide-initiative-to-integrate-mental-health-services-into-pediatric-primary-care
#10
Melissa A King, Lawrence S Wissow, Rebecca A Baum
BACKGROUND: Although there is evidence that mental health services can be delivered in pediatric primary care with good outcomes, few changes in service delivery have been seen over the past decade. Practices face a number of barriers, making interventions that address determinants of change at multiple levels a promising solution. However, these interventions may need appropriate organizational contexts in place to be successfully implemented. PURPOSE: The objective of this study was to test whether organizational context (culture, climate, structures/processes, and technologies) influenced uptake of a complex intervention to implement mental health services in pediatric primary care...
June 13, 2017: Health Care Management Review
https://www.readbyqxmd.com/read/28610561/blended-care-vs-usual-care-in-the-treatment-of-depressive-symptoms-and-disorders-in-general-practice-blending-study-protocol-of-a-non-inferiority-randomized-trial
#11
Btissame Massoudi, Marco H Blanker, Evelien van Valen, Hans Wouters, Claudi L H Bockting, Huibert Burger
BACKGROUND: The majority of patients with depressive disorders are treated by general practitioners (GPs) and are prescribed antidepressant medication. Patients prefer psychological treatments but they are under-used, mainly due to time constraints and limited accessibility. A promising approach to deliver psychological treatment is blended care, i.e. guided online treatment. However, the cost-effectiveness of blended care formatted as an online psychological treatment supported by the patients' own GP or general practice mental health worker (MHW) in routine primary care is unknown...
June 13, 2017: BMC Psychiatry
https://www.readbyqxmd.com/read/28607831/primary-care-integration-of-psychiatric-and-behavioral-health-services-a-primer-for-providers-and-case-report-of-local-implementation
#12
Anthony Ps Guerrero, Cori L Takesue, Jared Hn Medeiros, Aileen A Duran, Joseph W Humphry, Ryan M Lunsford, Diana V Shaw, Michael H Fukuda, Earl S Hishinuma
Mental health conditions are common, disabling, potentially life-threatening, and costly; however, they are mostly treatable with early detection and intervention. Unfortunately, mental healthcare is in significantly short supply both nationally and locally, and particularly in small, rural, and relatively isolated communities. This article provides physicians and other health practitioners with a primer on the basic rationale and principles of integrating behavioral healthcare - particularly psychiatric specialty care - in primary care settings, including effective use of teleconferencing...
June 2017: Hawai'i Journal of Medicine & Public Health: a Journal of Asia Pacific Medicine & Public Health
https://www.readbyqxmd.com/read/28606419/the-evolving-practice-of-psychiatry-in-the-era-of-integrated-care
#13
REVIEW
Robert Joseph, Rachel Kester, Colleen O'Brien, Hsiang Huang
BACKGROUND: Integrating behavioral health care into the primary care setting is increasingly recognized as an effective way to manage mental illness and substance use disorders on a population level in the United States. The term "integrated care," however, is used in many ways and encompasses several different models. OBJECTIVES: The aim of this article is to provide a conceptual framework to understand the landscape of models of integrated care and to use this framework to contrast the roles of behavioral health providers in integrated settings with those in traditional behavioral health delivery models...
April 13, 2017: Psychosomatics
https://www.readbyqxmd.com/read/28605243/intimate-partner-violence-and-its-resolution-among-mexican-americans
#14
Deborah Finfgeld-Connett
Intimate partner violence (IPV) affects the mental and physical health of Mexican women in the United States, and culture is thought to play a role in its prevention and resolution. Qualitative investigations are ideal for explicating context-specific aspects of these phenomena. Thus, a systematic review of 19 primary qualitative research reports was conducted to clearly articulate the process of IPV and its resolution among Mexican American women. Based on the findings, IPV is fueled by aspects of Mexican culture, and barriers exist that make its resolution challenging...
June 2017: Issues in Mental Health Nursing
https://www.readbyqxmd.com/read/28603552/problem-management-plus-pm-in-the-management-of-common-mental-disorders-in-a-specialized-mental-healthcare-facility-in-pakistan-study-protocol-for-a-randomized-controlled-trial
#15
Syed Usman Hamdani, Zainab Ahmed, Marit Sijbrandij, Huma Nazir, Aqsa Masood, Parveen Akhtar, Hania Amin, Richard A Bryant, Katie Dawson, Mark van Ommeren, Atif Rahman, Fareed Aslam Minhas
BACKGROUND: The World Health Organization (WHO) has developed Problem Management Plus (PM+), a 5-session, psychological intervention program delivered by trained non-specialist that addresses common mental disorders. The objectives of this study are to evaluate effectiveness and cost-effectiveness of PM+ in a specialized mental health care facility in Pakistan. METHODS: A single blind individual randomized controlled trial (RCT) will be carried out in the outpatient department of a specialized mental healthcare facility in Rawalpindi, Pakistan...
2017: International Journal of Mental Health Systems
https://www.readbyqxmd.com/read/28603550/health-system-governance-to-support-scale-up-of-mental-health-care-in-ethiopia-a-qualitative-study
#16
Charlotte Hanlon, Tigist Eshetu, Daniel Alemayehu, Abebaw Fekadu, Maya Semrau, Graham Thornicroft, Fred Kigozi, Debra Leigh Marais, Inge Petersen, Atalay Alem
BACKGROUND: Ethiopia is embarking upon a ground-breaking plan to address the high levels of unmet need for mental health care by scaling up mental health care integrated within primary care. Health system governance is expected to impact critically upon the success or otherwise of this important initiative. The objective of the study was to explore the barriers, facilitators and potential strategies to promote good health system governance in relation to scale-up of mental health care in Ethiopia...
2017: International Journal of Mental Health Systems
https://www.readbyqxmd.com/read/28597854/decentralizing-provision-of-mental-health-care-in-sri-lanka
#17
Neil Fernando, Thirupathy Suveendran, Chithramalee de Silva
In the past, mental health services in Sri Lanka were limited to tertiary-care institutions, resulting in a large treatment gap. Starting in 2000, significant efforts have been made to reconfigure service provision and to integrate mental health services with primary health care. This approach was supported by significant political commitment to establishing island-wide decentralized mental health care in the wake of the 2004 tsunami. Various initiatives were consolidated in The mental health policy of Sri Lanka 2005-2015, which called for implementation of a comprehensive community-based, decentralized service structure...
April 2017: WHO South-East Asia Journal of Public Health
https://www.readbyqxmd.com/read/28597853/depression-and-physical-noncommunicable-diseases-the-need-for-an-integrated-approach
#18
Nazneen Anwar, Pooja Patnaik Kuppili, Yatan Pal Singh Balhara
Depression is globally the third-leading cause of disability in terms of disability-adjusted life-years. Depression in patients with diseases such as cancer, diabetes mellitus, stroke or cardiovascular disease is 2-4-fold more prevalent than in people who do not have physical noncommunicable diseases, and may have a more prolonged course. The significant burden due to depression that is comorbid with chronic physical disease, coupled with limited resources, makes it a major public health challenge for low- and middle-income countries...
April 2017: WHO South-East Asia Journal of Public Health
https://www.readbyqxmd.com/read/28597852/mental-health-policies-in-south-east-asia-and-the-public-health-role-of-screening-instruments-for-depression
#19
Pratap Sharan, Rajesh Sagar, Saurabh Kumar
The World Health Organization (WHO) South-East Asia Region, which contributes one quarter of the world's population, has a significant burden due to mental illnesses. Mental health has been a low priority in most countries of the region. Although most of these countries have national mental health policies, implementation at ground level remains a huge challenge. Many countries in the region lack mental health legislation that can safeguard the rights of people with mental illnesses, and governments have allocated low budgets for mental health services...
April 2017: WHO South-East Asia Journal of Public Health
https://www.readbyqxmd.com/read/28597725/physicians-voices-what-skills-and-supports-are-needed-for-effective-practice-in-an-integrated-delivery-system-a-case-study-of-kaiser-permanente
#20
Benjamin Chesluk, Laura Tollen, Joy Lewis, Samantha DuPont, Marc H Klau
Payers are demanding that US health care become more accountable and integrated, posing new demands for physicians and the organizations that partner with them. We conducted focus groups with 30 physicians in a large integrated delivery system who had previous experience practicing in less integrated settings and asked about skills they need to succeed in this environment. Physicians identified 3 primary skills: orienting to teams and systems, engaging patients as individuals and as a panel, and integrating cost awareness into practice...
January 1, 2017: Inquiry: a Journal of Medical Care Organization, Provision and Financing
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