TY - JOUR
KW - General health
KW - Implementation framework
KW - integrated care
KW - Physical and behavioral health
AU - E. Smali
AU - R. M. Talley
AU - M. L. Goldman
AU - H. A. Pincus
AU - D. Woodlock
AU - H. Chung
A1 - 
AB - OBJECTIVE: General medical conditions among patients with mental and substance use disorders are often not adequately detected and managed in behavioral health settings. The project described in this study sought to investigate how behavioral health clinics used a new general health integration (GHI) framework to assess integration efforts. METHODS: Eleven community behavioral health clinics were introduced to a new continuum-based framework for use in GHI assessment. A multidisciplinary team in each clinic was tasked with identifying current GHI interventions according to several framework stages (preliminary, intermediate 1, intermediate 2, and advanced) among eight domains and 15 related subdomains. The clinics provided feedback on the framework's utility for GHI planning and advancement. RESULTS: The clinics could readily identify distinct integration interventions within each domain and subdomain. Clinics reported strengths in the domains of trauma-informed care, self-management support, social service linkages, and quality improvement. Opportunities for future advancement in integration of general health services were identified in the major domains of screening and referral, evidence-based treatments, care teams, and sustainability. The clinics also described potential benefits of the framework to further advance and implement GHI best practices. CONCLUSIONS: The clinics could use the framework as a practice assessment of integration efforts with minimal guidance and identify several evidence-based integration interventions. Some GHI interventions were seen as strengths and as opportunities for further advancement. Longitudinal evaluation among a larger number of and more geographically diverse behavioral health clinics seeking to advance their GHI practices will improve the GHI framework's generalizability and potential for dissemination.
AD - Montefiore Health System, Inc., New York City (Smali); Department of Psychiatry, University of Pennsylvania, Philadelphia (Talley); Department of Psychiatry and Behavioral Sciences, University of California, San Francisco (Goldman); Department of Psychiatry and Irving Institute for Clinical and Translational Research, Columbia University, and New York State Psychiatric Institute, New York City (Pincus); Institute for Community Living, New York City (Woodlock); Department of Psychiatry, Albert Einstein College of Medicine and Montefiore Health System, New York City (Chung).; Montefiore Health System, Inc., New York City (Smali); Department of Psychiatry, University of Pennsylvania, Philadelphia (Talley); Department of Psychiatry and Behavioral Sciences, University of California, San Francisco (Goldman); Department of Psychiatry and Irving Institute for Clinical and Translational Research, Columbia University, and New York State Psychiatric Institute, New York City (Pincus); Institute for Community Living, New York City (Woodlock); Department of Psychiatry, Albert Einstein College of Medicine and Montefiore Health System, New York City (Chung).; Montefiore Health System, Inc., New York City (Smali); Department of Psychiatry, University of Pennsylvania, Philadelphia (Talley); Department of Psychiatry and Behavioral Sciences, University of California, San Francisco (Goldman); Department of Psychiatry and Irving Institute for Clinical and Translational Research, Columbia University, and New York State Psychiatric Institute, New York City (Pincus); Institute for Community Living, New York City (Woodlock); Department of Psychiatry, Albert Einstein College of Medicine and Montefiore Health System, New York City (Chung).; Montefiore Health System, Inc., New York City (Smali); Department of Psychiatry, University of Pennsylvania, Philadelphia (Talley); Department of Psychiatry and Behavioral Sciences, University of California, San Francisco (Goldman); Department of(TRUNCATED)
BT - Psychiatric services (Washington, D.C.)
C5 - Opioids & Substance Use
CP - 6
DO - 10.1176/appi.ps.202000708
IS - 6
JF - Psychiatric services (Washington, D.C.)
LA - eng
M1 - Journal Article
N2 - OBJECTIVE: General medical conditions among patients with mental and substance use disorders are often not adequately detected and managed in behavioral health settings. The project described in this study sought to investigate how behavioral health clinics used a new general health integration (GHI) framework to assess integration efforts. METHODS: Eleven community behavioral health clinics were introduced to a new continuum-based framework for use in GHI assessment. A multidisciplinary team in each clinic was tasked with identifying current GHI interventions according to several framework stages (preliminary, intermediate 1, intermediate 2, and advanced) among eight domains and 15 related subdomains. The clinics provided feedback on the framework's utility for GHI planning and advancement. RESULTS: The clinics could readily identify distinct integration interventions within each domain and subdomain. Clinics reported strengths in the domains of trauma-informed care, self-management support, social service linkages, and quality improvement. Opportunities for future advancement in integration of general health services were identified in the major domains of screening and referral, evidence-based treatments, care teams, and sustainability. The clinics also described potential benefits of the framework to further advance and implement GHI best practices. CONCLUSIONS: The clinics could use the framework as a practice assessment of integration efforts with minimal guidance and identify several evidence-based integration interventions. Some GHI interventions were seen as strengths and as opportunities for further advancement. Longitudinal evaluation among a larger number of and more geographically diverse behavioral health clinics seeking to advance their GHI practices will improve the GHI framework's generalizability and potential for dissemination.
PY - 2022
SN - 1557-9700; 1075-2730
SP - 636
EP - 641+
T1 - A Continuum-Based Framework as a Practice Assessment Tool for Integration of General Health in Behavioral Health Care
T2 - Psychiatric services (Washington, D.C.)
TI - A Continuum-Based Framework as a Practice Assessment Tool for Integration of General Health in Behavioral Health Care
U1 - Opioids & Substance Use
U2 - 34555921
U3 - 10.1176/appi.ps.202000708
VL - 73
VO - 1557-9700; 1075-2730
Y1 - 2022
Y2 - Sep 24
ER -