TY - JOUR
KW - Attitude of Health Personnel
KW - Cooperative Behavior
KW - Decision Making
KW - Depression/therapy
KW - Feasibility Studies
KW - Focus Groups
KW - Great Britain
KW - Humans
KW - Interprofessional Relations
KW - Interviews as Topic
KW - Mental Health Services/organization & administration/standards
KW - Patient Acceptance of Health Care/statistics & numerical data
KW - Patient Care Team
KW - Primary Health Care/methods
KW - Social Support
KW - Telephone
AU - D. A. Richards
AU - A. J. Lankshear
AU - J. Fletcher
AU - A. Rogers
AU - M. Barkham
AU - P. Bower
AU - L. Gask
AU - S. Gilbody
AU - K. Lovell
A1 - 
AB - OBJECTIVE: This study aimed to explore the views of stakeholders including patients, general practitioners (GPs) and mental health workers on the feasibility, acceptability and barriers to a collaborative care model for treatment of depression within the context of U.K. primary health care. METHOD: We used semistructured interviews and focus groups with a purposive sample of 11 patients and 38 professionals from a wide selection of primary and secondary care mental health services, as well as framework analysis using a "constant comparative" approach to identify key concepts and themes. RESULTS: Regular contact for patients with depression is acceptable and valued by both patients and professionals. However, patients value support, whereas professionals focus on information. To be acceptable to patients, contacts about medication or psychosocial support must minimize the potential for patient disempowerment. The use of the telephone is convenient and lends anonymity, but established mental health workers think it will impair their judgments. While patients merely identified the need for skilled case managers, GPs preferred established professionals; however, these workers did not see themselves in this role. All involved were cautious about deploying new workers. Additional barriers included practical and organizational issues. CONCLUSIONS: Although a telephone-delivered mix of medication support and low-intensity psychological intervention is generally acceptable, significant issues to be addressed include the values of the current mental health workforce, fears about new workers' experience and competence, the balance of face-to-face and telephone contacts and case manager education in nonspecific skills necessary to develop a therapeutic alliance, as well as the knowledge and skills required for education, medication support and behavioral activation. Qualitative research can add value to careful modeling of collaborative care prior to international implementation.
BT - General hospital psychiatry
C5 - HIT & Telehealth
CP - 4
CY - United States
DO - 10.1016/j.genhosppsych.2006.03.005
IS - 4
JF - General hospital psychiatry
N2 - OBJECTIVE: This study aimed to explore the views of stakeholders including patients, general practitioners (GPs) and mental health workers on the feasibility, acceptability and barriers to a collaborative care model for treatment of depression within the context of U.K. primary health care. METHOD: We used semistructured interviews and focus groups with a purposive sample of 11 patients and 38 professionals from a wide selection of primary and secondary care mental health services, as well as framework analysis using a "constant comparative" approach to identify key concepts and themes. RESULTS: Regular contact for patients with depression is acceptable and valued by both patients and professionals. However, patients value support, whereas professionals focus on information. To be acceptable to patients, contacts about medication or psychosocial support must minimize the potential for patient disempowerment. The use of the telephone is convenient and lends anonymity, but established mental health workers think it will impair their judgments. While patients merely identified the need for skilled case managers, GPs preferred established professionals; however, these workers did not see themselves in this role. All involved were cautious about deploying new workers. Additional barriers included practical and organizational issues. CONCLUSIONS: Although a telephone-delivered mix of medication support and low-intensity psychological intervention is generally acceptable, significant issues to be addressed include the values of the current mental health workforce, fears about new workers' experience and competence, the balance of face-to-face and telephone contacts and case manager education in nonspecific skills necessary to develop a therapeutic alliance, as well as the knowledge and skills required for education, medication support and behavioral activation. Qualitative research can add value to careful modeling of collaborative care prior to international implementation.
PP - United States
PY - 2006
SN - 0163-8343; 0163-8343
SP - 296
EP - 305
EP - 
T1 - Developing a U.K. protocol for collaborative care: a qualitative study
T2 - General hospital psychiatry
TI - Developing a U.K. protocol for collaborative care: a qualitative study
U1 - HIT & Telehealth
U2 - 16814628
U3 - 10.1016/j.genhosppsych.2006.03.005
VL - 28
VO - 0163-8343; 0163-8343
Y1 - 2006
ER -