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Primary care mental health integration

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https://www.readbyqxmd.com/read/29330238/changing-patterns-of-mental-health-care-use-the-role-of-integrated-mental-health-services-in-veteran-affairs-primary-care
#1
Lucinda B Leung, Jean Yoon, Lisa V Rubenstein, Edward P Post, Maureen E Metzger, Kenneth B Wells, Catherine A Sugar, José J Escarce
OBJECTIVE: Aiming to foster timely, high-quality mental health care for Veterans, VA's Primary Care-Mental Health Integration (PC-MHI) embeds mental health specialists in primary care and promotes care management for depression. PC-MHI and patient-centered medical home providers work together to provide the bulk of mental health care for primary care patients with low-to-moderate-complexity mental health conditions. This study examines whether increasing primary care clinic engagement in PC-MHI services is associated with changes in patient health care utilization and costs...
January 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29327162/explication-of-a-behavioral-health-primary-care-integration-learning-collaborative-and-its-quality-improvement-implications
#2
Martha Okafor, Victor Ede, Rosemary Kinuthia, David Satcher
In an effort to tackle fragmented care in the US healthcare delivery system, we explored the use of learning collaborative (LC) to advance integration of behavioral health and primary care as one of the potential solutions to a holistic approach to the delivery of quality healthcare to individuals with physical and mental illness. How a diverse group of primary care and behavioral health providers formed a Community of Practice (CoP) with a common purpose and shared vision to advance integrated care using a LC approach is described...
January 11, 2018: Community Mental Health Journal
https://www.readbyqxmd.com/read/29322290/psychologists-and-pediatricians-in-the-primary-care-sandbox-communication-is-key-to-cooperative-play
#3
Anne E Pidano, Prerna Arora, Polly Y Gipson, Bradley O Hudson, Kriston B Schellinger
Recent literature, public policy, and funding opportunities call attention to the need for better increased integration of health and mental health care services in primary care settings so as to best meet the needs of children and families. There are many benefits to such integration, but pediatric primary care providers (PCPs) face multiple barriers to identifying and managing patients with mental health difficulties. One way to address this problem is through the integration of psychologists into primary care settings who can collaborate with PCPs to provide integrated behavioral health care to youth and families...
January 10, 2018: Journal of Clinical Psychology in Medical Settings
https://www.readbyqxmd.com/read/29316883/active-ingredients-of-a-person-centred-intervention-for-people-on-hiv-treatment-analysis-of-mixed-methods-trial-data
#4
Keira Lowther, Richard Harding, Victoria Simms, Aabid Ahmed, Zipporah Ali, Nancy Gikaara, Lorraine Sherr, Hellen Kariuki, Irene J Higginson, Lucy Ellen Selman
BACKGROUND: A new model of care is required to meet the changing needs of people living with HIV (PLWH), particularly in low and middle-income countries, where prevalence is highest. We evaluated a palliative care intervention for PLWH in Mombasa, Kenya. Although we found no effect on pain (primary outcome), there was a positive effect on mental health (secondary outcome) in the intervention group. To inform replication and implementation, we have determined the active ingredients of the intervention and their mechanisms of action...
January 10, 2018: BMC Infectious Diseases
https://www.readbyqxmd.com/read/29316451/an-innovative-model-to-coordinate-healthcare-and-social-services-for-people-with-serious-mental-illness-a-mixed-methods-case-study-of-maryland-s-medicaid-health-home-program
#5
Emma E McGinty, Alene Kennedy-Hendricks, Sarah Linden, Seema Choksy, Elizabeth Stone, Gail L Daumit
OBJECTIVE: We conducted a case study examining implementation of Maryland's Medicaid health home program, a unique model for integration of behavioral, somatic, and social services for people with serious mental illness (SMI) in the psychiatric rehabilitation program setting. METHOD: We conducted interviews and surveys with health home leaders (N=72) and front-line staff (N=627) representing 46 of the 48 total health home programs active during the November 2015-December 2016 study period...
December 16, 2017: General Hospital Psychiatry
https://www.readbyqxmd.com/read/29311178/using-state-administrative-data-to-identify-social-complexity-risk-factors-for-children
#6
Kimberly C Arthur, Barbara A Lucenko, Irina V Sharkova, Jingping Xing, Rita Mangione-Smith
PURPOSE: Screening for social determinants of health is challenging but critically important for optimizing child health outcomes. We aimed to test the feasibility of using an integrated state agency administrative database to identify social complexity risk factors and examined their relationship to emergency department (ED) use. METHODS: We conducted a retrospective cohort study among children younger than 18 years with Washington State Medicaid insurance coverage (N = 505,367)...
January 2018: Annals of Family Medicine
https://www.readbyqxmd.com/read/29302544/morbidity-pattern-and-its-sociodemographic-determinants-among-elderly-population-of-raichur-district-karnataka-india
#7
Leyanna Susan George, Sanjay Deshpande, M K Krishna Kumar, Ramesh S Patil
Context: India is an "aging nation" with 7.7% of its population being above 60 years of age. It has resulted in a rise of both physical and mental health morbidities. Aims: This study aimed to gather information regarding the morbidity pattern and its sociodemographic determinants among the elderly residing in the rural villages of Raichur, to understand the need for geriatric health-care facilities. Settings and Design: This community-based cross-sectional study was carried out in six rural villages of Raichur District, of which 230 elderly were selected randomly...
April 2017: Journal of Family Medicine and Primary Care
https://www.readbyqxmd.com/read/29288142/patient-reported-outcome-measures-utility-for-predicting-spinal-surgery-in-an-integrated-spine-practice
#8
James R Babington, Alicia Edwards, Anna Wright, Taitea Dykstra, Andrew S Friedman, Rajiv K Sethi
BACKGROUND: For the majority of patients, spinal surgery is an elective treatment. The decision as to when and if to pursue surgery is complicated and influenced by a myriad of factors including pain intensity and duration, impact on functional activities, referring physician recommendation and surgeon preference. By understanding the factors that lead a patient to choose surgery we may better understand the decision making process, improve outcomes, and provide more effective care. OBJECTIVE: To investigate the relationship between patient-reported outcome measures (PROMs) at initial physiatry clinic consultation and subsequent decision to pursue surgical treatment...
December 26, 2017: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/29284438/randomised-control-trial-of-the-effectiveness-of-an-integrated-psychosocial-health-promotion-intervention-aimed-at-improving-health-and-reducing-substance-use-in-established-psychosis-impact
#9
Fiona Gaughran, Daniel Stahl, Khalida Ismail, Kathryn Greenwood, Zerrin Atakan, Poonam Gardner-Sood, Brendon Stubbs, David Hopkins, Anita Patel, John Lally, Philippa Lowe, Maurice Arbuthnot, Diana Orr, Sarah Corlett, Jonas Eberhard, Anthony S David, Robin Murray, Shubulade Smith
BACKGROUND: People with psychosis have a reduced life expectancy of 10-20 years, largely due to cardiovascular disease. This trial aimed to determine the effectiveness of a modular health promotion intervention (IMPaCT Therapy) in improving health and reducing cardiovascular risk in psychosis. METHODS: A multicentre, two arm, parallel cluster RCT was conducted across five UK mental health NHS trusts. Community care coordinators (CC) were randomly assigned to training and supervision in delivering IMPaCT Therapy or treatment as usual (TAU) to current patients with psychosis (cluster)...
December 28, 2017: BMC Psychiatry
https://www.readbyqxmd.com/read/29273021/randomised-controlled-trial-to-improve-health-and-reduce-substance-use-in-established-psychosis-impact-cost-effectiveness-of-integrated-psychosocial-health-promotion
#10
Margaret Heslin, Anita Patel, Daniel Stahl, Poonam Gardner-Sood, Manyara Mushore, Shubulade Smith, Kathryn Greenwood, Oluwadamilola Onagbesan, Conan O'Brien, Catherine Fung, Ruth Ohlsen, David Hopkins, Philippa Lowe, Maurice Arbuthnot, Stan Mutatsa, Gill Todd, Anna Kolliakou, John Lally, Brendon Stubbs, Khalida Ismail, Anthony David, Robin Murray, Zerrin Atakan, Fiona Gaughran
BACKGROUND: There is mounting evidence that people with severe mental illness have unhealthy lifestyles, high rates of cardiovascular and metabolic diseases, and greater risk of early mortality. This study aimed to assess the cost-effectiveness of a health promotion intervention seeking to improve physical health and reduce substance use in people with psychosis. METHODS: Participants with a psychotic disorder, aged 18-65 years old and registered on an enhanced care approach programme or equivalent were recruited from community mental health teams in six mental health trusts in England...
December 22, 2017: BMC Psychiatry
https://www.readbyqxmd.com/read/29261452/attitudes-towards-mental-health-and-the-integration-of-mental-health-services-into-primary-health-care-a-cross-sectional-survey-among-health-care-workers-in-lvea-em-district-cambodia
#11
Maria Alfredsson, Miguel San Sebastian, Bhoomikumar Jeghannathan
BACKGROUND: Cambodia is a country where the resources for treating mental health disorders are far from sufficient. One strategy to narrow the treatment gap is to integrate mental health into primary health care (PHC). Understanding the knowledge and attitudes towards mental health integration that health-care workers have is important for assessing the challenges and opportunities when planning a potential integration project. OBJECTIVE: The aim of this study was to assess these basic conditions in Lvea Em District, Cambodia...
2017: Global Health Action
https://www.readbyqxmd.com/read/29242177/implementing-a-mental-health-care-program-and-home-based-training-for-mothers-of-children-with-autism-spectrum-disorder-in-an-urban-population-in-bangladesh-protocol-for-a-feasibility-assessment-study
#12
Aliya Naheed, Kamrun Nahar Koly, Helal Uddin Ahmed, Shaheen Akhter, M M Jalal Uddin, Mary C Smith Fawzi, Subhash Chandir, Muzharul Mannan, Saima Hossain, Charles Nelson, Kerim Munir
BACKGROUND: Mothers of children with autism spectrum disorder (ASD) have reported a higher level of depression than mothers of children with other neurodevelopmental disorders in both developed and developing countries. Mothers are the lifetime caregivers of children with ASD, and a high burden of depression can negatively impact their ability to provide care. However, access to mental health services in primary care is limited, given the scarcity of qualified providers in Bangladesh...
December 14, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/29241440/primary-care-mental-health-integration-in-the-va-shifting-mental-health-services-for-common-mental-illnesses-to-primary-care
#13
Lucinda B Leung, Jean Yoon, José J Escarce, Edward P Post, Kenneth B Wells, Catherine A Sugar, Elizabeth M Yano, Lisa V Rubenstein
OBJECTIVE: Primary care-mental health integration (PC-MHI) aims to increase access to general mental health specialty (MHS) care for primary care patients thereby decreasing referrals to non-primary care-based MHS services. It remains unclear whether new patterns of usage of MHS services reflect good mental health care. This study examined the relationship between primary care clinic engagement in PC-MHI and use of different MHS services. METHODS: This was a retrospective longitudinal cohort study of 66,638 primary care patients with mental illnesses in 29 Southern California Veterans Affairs clinics (2008-2013)...
December 15, 2017: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/29241436/integrated-primary-care-in-assertive-community-treatment
#14
Benjamin F Henwood, Elizabeth Siantz, Debra R Hrouda, Debbie Innes-Gomberg, Todd P Gilmer
Assertive community treatment (ACT) has the potential to serve as a medical home for adults with serious mental illness, a population that experiences some of the most significant health disparities in the United States. Using site visit methodology, the authors describe partnerships that were created between five ACT programs and federally qualified health centers (FQHCs) to provide integrated behavioral health and primary care. The authors examined rates of screening for common chronic conditions. The programs used three distinct approaches: two programs colocated ACT teams at an FQHC, two programs employed primary care providers who split their time between the FQHC and the ACT program, and one program embedded a primary care provider within the ACT team...
December 15, 2017: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/29217389/competencies-for-engaging-high-needs-patients-in-primary-care
#15
Michael J Yedidia
BACKGROUND: Patients who heavily utilize hospitals and emergency departments frequently have complex needs requiring services spanning medical, behavioral, and social service sectors. This study identifies essential competencies for caring for high-needs patients and highlights their importance to primary care delivery. METHODS: Transcripts of in-depth interviews with 30 clinical and administrative staff at 23 complex care programs across the United States were analyzed using standard qualitative techniques...
December 4, 2017: Healthcare
https://www.readbyqxmd.com/read/29204014/mental-healthcare-delivery-in-rural-greece-a-10-year-account-of-a-mobile-mental-health-unit
#16
Vaios Peritogiannis, Thiresia Manthopoulou, Afroditi Gogou, Venetsanos Mavreas
Introduction: Patients living in rural and remote areas may have limited access to mental healthcare due to lack of facilities and socioeconomic reasons, and this is the case of rural areas in Eastern Europe countries. In Greece, community mental health service delivery in rural areas has been implemented through the development of the Mobile Mental Health Units (MMHUs). Methods: We present a 10-year account of the operation of the MMHU of the prefectures of Ioannina and Thesprotia (MMHU I-T) and report on the impact of the service on mental health delivery in the catchment area...
October 2017: Journal of Neurosciences in Rural Practice
https://www.readbyqxmd.com/read/29201658/closing-the-gap-decentralising-mental-health-care-to-primary-care-centres-in-one-rural-district-of-rwanda
#17
B Nyirandagijimana, J K Edwards, E Venables, E Ali, C Rusangwa, H Mukasakindi, R Borg, M Fabien, M Tharcisse, A Nshimyiryo, P H Park, G J Raviola, S L Smith
Setting: Programmes that integrate mental health care into primary care settings could reduce the global burden of mental disorders by increasing treatment availability in resource-limited settings, including Rwanda. Objective: We describe patient demographics, service use and retention of patients in care at health centres (HC) participating in an innovative primary care integration programme, compared to patients using existing district hospital-based specialised out-patient care. Design: This was a retrospective cohort study using routinely collected data from six health centres and one district hospital from October 2014 to March 2015...
September 21, 2017: Public Health Action
https://www.readbyqxmd.com/read/29199920/consumers-understanding-and-expectations-of-a-community-based-recovery-oriented-mental-health-rehabilitation-unit-a-pragmatic-grounded-theory-analysis
#18
Stephen Parker, Frances Dark, Ellie Newman, Dominic Hanley, William McKinlay, Carla Meurk
AIMS: Incorporating consumer perspectives into mental health services design is important in working to deliver recovery-oriented care. One of the challenges faced in mental health rehabilitation services is limited consumer engagement with the available support. Listening to consumers' expectations of mental health services, and what they hope to achieve, provides an opportunity to examine the alignment between existing services and the priorities and preferences of the people who use them...
December 4, 2017: Epidemiology and Psychiatric Sciences
https://www.readbyqxmd.com/read/29199842/a-preliminary-survey-of-pediatricians-experiences-with-and-preferences-for-communication-with-mental-health-specialists
#19
Duncan G Campbell, Andrew Downs, William J Meyer, Megan M McKittrick, Nicole M Simard, Patricia O'Brien
INTRODUCTION: Pediatricians are more likely than mental health (MH) specialists to manage children's MH concerns, and multiple factors complicate their abilities to do so adequately. Integrated care initiatives mitigate systems-related shortcomings that hamstring MH management in primary care. These initiatives, which improve outcomes for adults, are not widespread for youth. Integrated health care for children with MH concerns requires regular collaborative communication among pediatricians and MH specialists...
December 4, 2017: Families, Systems & Health: the Journal of Collaborative Family Healthcare
https://www.readbyqxmd.com/read/29197414/integrated-mental-health-care-and-vocational-rehabilitation-to-improve-return-to-work-rates-for-people-on-sick-leave-because-of-depression-and-anxiety-the-danish-ibbis-trial-study-protocol-for-a-randomized-controlled-trial
#20
Rie Poulsen, Andreas Hoff, Jonas Fisker, Carsten Hjorthøj, Lene Falgaard Eplov
BACKGROUND: Depression and anxiety are among the largest contributors to the global burden of disease and have negative effects on both the individual and society. Depression and anxiety are very likely to influence the individual's work ability, and up to 40% of the people on sick leave in Denmark have depression and/or anxiety. There is no clear evidence that treatment alone will provide sufficient support for vocational recovery in this group. Integrated vocational and health care services have shown good effects on return to work in other, similar welfare contexts...
December 2, 2017: Trials
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