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Integrated mental health, collaborative care

Gregory P Beehler, Paul R King, Christina L Vair, Julie Gass, Jennifer S Funderburk
The VA has integrated psychologists and other licensed mental health providers, known collectively as co-located collaborative care (CCC) providers, into patients' primary care medical homes to improve mental health services for veterans. However, it is unclear if CCC providers are routinely using mental health measures as part of evidence-based, coordinated care. This study aimed to determine the prevalence and predictors of CCC provider utilization of brief, validated measures. A retrospective review of VA electronic medical records from 8403 veterans diagnosed with depression, posttraumatic stress disorder, or anxiety disorder was conducted...
October 21, 2016: Journal of Clinical Psychology in Medical Settings
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
Ann M Mayo, Melodee Harris, Bill Buron
Specific changes to the national clinical nurse specialist (CNS) certification are necessitating a move away the psychiatric/mental health (P/MH) CNS population focus. However, a rapidly increasing older adult population with P/MH comorbidities such as depression and anxiety means that the adult-gerontology CNS (AGCNS) will likely be coordinating much of the complex care needs of this vulnerable population. Therefore, strategies are needed to ensure AGCNSs are competent in advanced practice P/MH nursing. In addition, at this critical time in the redesign of healthcare, the Institute of Medicine has made interprofessional practice center stage for healthcare professional education...
November 2016: Clinical Nurse Specialist CNS
Doyanne Darnell, Stephen O'Connor, Amy Wagner, Joan Russo, Jin Wang, Leah Ingraham, Kirsten Sandgren, Douglas Zatzick
OBJECTIVE: Injured patients presenting to acute care medical settings have high rates of posttraumatic stress disorder (PTSD) and comorbidities, such as depression and substance use disorders. Integrating behavioral interventions that target symptoms of PTSD and comorbidities into the acute care setting can overcome common barriers to obtaining mental health care. This study examined the feasibility and acceptability of embedding elements of cognitive-behavioral therapy (CBT) in the delivery of routine postinjury care management...
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
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
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
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
Lauren Schwartz, Anthony Holland, Elisabeth Dykens, Theresa Strong, Elizabeth Roof, Jessica Bohonowych
: This paper reports on the 'Prader-Willi Syndrome (PWS) Mental Health Research Strategy Workshop' that took place in March 2015. PWS is characterized by a complex phenotype affecting multiple systems with a high prevalence of maladaptive behaviours, and neuropsychiatric illness. Prader Willi syndrome results from the absence of paternally derived alleles located at the imprinted chromosomal locus, 15q11-13. The goal of the workshop was to highlight the state of the science of the mental health of people with this rare neurodevelopmental disorder...
September 29, 2016: Orphanet Journal of Rare Diseases
D Chisholm, M Heslin, S Docrat, S Nanda, R Shidhaye, N Upadhaya, M Jordans, J Abdulmalik, S Olayiwola, O Gureje, D Kizza, J Mugisha, F Kigozi, C Hanlon, M Adugna, R Sanders, C Pretorius, G Thornicroft, C Lund
BACKGROUND: Although financing represents a critical component of health system strengthening and also a defining concern of efforts to move towards universal health coverage, many countries lack the tools and capacity to plan effectively for service scale-up. As part of a multi-country collaborative study (the Emerald project), we set out to develop, test and apply a fully integrated health systems resource planning and health impact tool for mental, neurological and substance use (MNS) disorders...
September 19, 2016: Epidemiology and Psychiatric Sciences
Pasquale Roberge, Catherine Hudon, Alan Pavilanis, Marie-Claude Beaulieu, Annie Benoit, Hélène Brouillet, Isabelle Boulianne, Anna De Pauw, Serge Frigon, Isabelle Gaboury, Martine Gaudreault, Ariane Girard, Marie Giroux, Élyse Grégoire, Line Langlois, Martin Lemieux, Christine Loignon, Alain Vanasse
BACKGROUND: The prevalence of comorbid anxiety and depressive disorders is high among patients with chronic diseases in primary care, and is associated with increased morbidity and mortality rates. The detection and treatment of common mental disorders in patients with chronic diseases can be challenging in the primary care setting. This study aims to explore the perceived needs, barriers and facilitators for the delivery of mental health care for patients with coexisting common mental disorders and chronic diseases in primary care from the clinician and patient perspectives...
2016: BMC Family Practice
Joanne Reeve, Lucy Cooper, Sean Harrington, Peter Rosbottom, Jane Watkins
BACKGROUND: Health services face the challenges created by complex problems, and so need complex intervention solutions. However they also experience ongoing difficulties in translating findings from research in this area in to quality improvement changes on the ground. BounceBack was a service development innovation project which sought to examine this issue through the implementation and evaluation in a primary care setting of a novel complex intervention. METHODS: The project was a collaboration between a local mental health charity, an academic unit, and GP practices...
2016: BMC Health Services Research
Rachelle Ashcroft, Jose Silveira, Kwame Mckenzie
BACKGROUND: An opportunity to address the needs of patients with common mental disorders (CMDs) resides in primary care. Barriers are restricting availability of treatment for CMDs in primary care. By understanding the incentives that promote and the disincentives that deter treatment for CMDs in a collaborative primary care context, this study aims to help contribute to goals of greater access to mental healthcare. METHOD: A qualitative pilot study using semi-structured interviews with thematic analysis...
August 2016: Healthcare Policy, Politiques de Santé
Anna C Muriel, Joanne Wolfe, Susan D Block
As the field of Pediatric Palliative Care continues to develop, it is important to consider the scope of practice and the utility of collaboration with other specialties, including child and adolescent psychiatry. The integration of psychiatry and palliative medicine has been explored in adult practice, but has not yet been elaborated in pediatrics. This article proposes a clinical model of care that highlights the overlapping and unique expertise that each discipline brings, in a continuum of collaboration, and proposes an integrated care model for the most complex patients and families...
August 23, 2016: Journal of Palliative Medicine
Dimiter V Dimitrov
OBJECTIVES: A number of technologies can reduce overall costs for the prevention or management of chronic illnesses. These include devices that constantly monitor health indicators, devices that auto-administer therapies, or devices that track real-time health data when a patient self-administers a therapy. Because they have increased access to high-speed Internet and smartphones, many patients have started to use mobile applications (apps) to manage various health needs. These devices and mobile apps are now increasingly used and integrated with telemedicine and telehealth via the medical Internet of Things (mIoT)...
July 2016: Healthcare Informatics Research
Morenike O Folayan, Abiola A Adeniyi, Elizabeth O Oziegbe, Adesegun O Fatusi, Abigail Harrison
BACKGROUND: Globally, young people account for 15.5% of the total global disability-adjusted life-years burden for all age groups. They face mental health, nutritional problems, accidental and intentional injuries, sexual and reproductive health problems, and substance abuse. These health challenges have effects on their oral health. This paper discusses the oral health problems adolescents face and suggests approaches for providing integrated oral and general health care for adolescents...
August 9, 2016: International Journal of Adolescent Medicine and Health
Robin M A Clarke, Jessica Jeffrey, Mark Grossman, Thomas Strouse, Michael Gitlin, Samuel A Skootsky
Patients with behavioral health disorders often have worse health outcomes and have higher health care utilization than patients with medical diseases alone. As such, people with behavioral health conditions are important populations for accountable care organizations (ACOs) seeking to improve the efficiency of their delivery systems. However, ACOs have historically faced numerous barriers in implementing behavioral health population-based programs, including acquiring reimbursement, recruiting providers, and integrating new services...
August 1, 2016: Health Affairs
Carianne M Hunt, Michael Spence, Anne McBride
BACKGROUND: On average, people with schizophrenia and psychosis die 13-30 years sooner than the general population (World Psychiatry 10 (1):52-77, 2011). Mental and physical health care is often provided by different organisations, different practitioners and in different settings which makes collaborative care difficult. Research is needed to understand and map the impact of new collaborative ways of working at the primary/secondary care interface (PloS One 7 (5); e36468). The evaluation presented in this paper was designed to explore the potential of a Community and Physical Health Co-ordinator role (CPHC) (CPHCs were previously Care Co-ordinators within the Community Mental Health Team, Community in the title CPHC refers to Community Mental Health) and Multi-Disciplinary Team (MDT) meetings across primary and community care, with the aim of improving collaboration of mental and physical health care for service users with Severe Mental Illness (SMI)...
2016: BMC Family Practice
Hannah Dale, Alyssa Lee
BACKGROUND: Significant challenges exist within primary care services in the United Kingdom (UK). These include meeting current demand, financial pressures, an aging population and an increase in multi-morbidity. Psychological services also struggle to meet waiting time targets and to ensure increased access to psychological therapies. Innovative ways of delivering effective primary care and psychological services are needed to improve health outcomes. In this article we argue that integrated care models that incorporate behavioural health care are part of the solution, which has seldom been argued in relation to UK primary care...
2016: BMC Family Practice
André Janse van Rensburg, Pieter Fourie
BACKGROUND: Mental illness is a well-known challenge to global development, particularly in low-to-middle income countries. A key health systems response to mental illness is different models of integrated health care, especially popular in the South African Development Community (SADC) region. This complex construct is often not well-defined in health policy, hampering implementation efforts. A key development in this vein has been the Rainbow Model of integrated care, a comprehensive framework and taxonomy of integrated care based on the integrative functions of primary care...
2016: International Journal of Mental Health Systems
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