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The Literature Collection contains over 10,000 references for published and grey literature on the integration of behavioral health and primary care. Learn More
Use the Search feature below to find references for your terms across the entire Literature Collection, or limit your searches by Authors, Keywords, or Titles and by Year, Type, or Topic. View your search results as displayed, or use the options to: Show more references per page; Sort references by Title or Date; and Refine your search criteria. Expand an individual reference to View Details. Full-text access to the literature may be available through a link to PubMed, a DOI, or a URL. References may also be exported for use in bibliographic software (e.g., EndNote, RefWorks, Zotero).
457 Results
221
Initial evaluation, diagnosis, and treatment of anorexia nervosa and bulimia nervosa
Type: Journal Article
Year: 2015
Publication Place: United States
Abstract: Eating disorders are life-threatening conditions that are challenging to address; however, the primary care setting provides an important opportunity for critical medical and psychosocial intervention. The recently published Diagnostic and Statistical Manual of Mental Disorders, 5th ed., includes updated diagnostic criteria for anorexia nervosa (e.g., elimination of amenorrhea as a diagnostic criterion) and for bulimia nervosa (e.g., criterion for frequency of binge episodes decreased to an average of once per week). In addition to the role of environmental triggers and societal expectations of body size and shape, research has suggested that genes and discrete biochemical signals contribute to the development of eating disorders. Anorexia nervosa and bulimia nervosa occur most often in adolescent females and are often accompanied by depression and other comorbid psychiatric disorders. For low-weight patients with anorexia nervosa, virtually all physiologic systems are affected, ranging from hypotension and osteopenia to life-threatening arrhythmias, often requiring emergent assessment and hospitalization for metabolic stabilization. In patients with frequent purging or laxative abuse, the presence of electrolyte abnormalities requires prompt intervention. Family-based treatment is helpful for adolescents with anorexia nervosa, whereas short-term psychotherapy, such as cognitive behavior therapy, is effective for most patients with bulimia nervosa. The use of psychotropic medications is limited for anorexia nervosa, whereas treatment studies have shown a benefit of antidepressant medications for patients with bulimia nervosa. Treatment is most effective when it includes a multidisciplinary, teambased approach.
Topic(s):
General Literature
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Reference Links: View the PubMed citation for Initial evaluation, diagnosis, and treatment of anorexia nervosa and bulimia nervosa
222
Innovations in primary mental healthcare
Type: Journal Article
Year: 2013
Publication Place: Australia
Abstract: OBJECTIVE: We review the evidence on innovations in Tier 2 of the Access to Allied Psychological Services (ATAPS) program, which is designed to facilitate the provision of primary mental healthcare to hard-to-reach and at-risk population groups (including women with perinatal depression, people at risk of self-harm or suicide, people experiencing or at risk of homelessness, people affected by the 2009 Victorian bushfires, people in remote locations, Aboriginal and Torres Strait Islanders and children with mental disorders) and the trialling of new modalities of service delivery (e.g. telephone-based or web-based CBT). The primary focus is on the uptake, outcomes and issues associated with the provision of ATAPS Tier 2. METHODS: Drawing on data from an ongoing national ATAPS evaluation, including a national minimum dataset, key informant interviews and surveys, the impact of ATAPS innovations is analysed and illustrated through program examples. RESULTS: ATAPS Tier 2 facilitates access to, uptake of and positive clinical outcomes from primary mental healthcare for population groups with particular needs, although it requires periods of time to implement locally. CONCLUSIONS: Relatively simple innovations in mental health program design can have important practical ramifications for service provision, extending program reach and improving mental health outcomes for target populations. What is known about the topic? It is recognised that innovative approaches are required to tailor mental health programs for hard-to-reach and at-risk population groups. Divisions of General Practice have implemented innovations in the Access to Allied Psychological Services (ATAPS) program for several years. What does this paper add? Drawing on data from an ongoing national ATAPS evaluation, this paper presents a systematic analysis of the uptake, outcomes and issues associated with provision of the innovative ATAPS program. What are the implications for practitioners? The findings highlight the benefits of introducing innovations in primary mental healthcare in terms of increased access to care and positive consumer outcomes. They also identify challenges to and facilitators of the implementation process, which can inform innovation efforts in other primary care contexts.
Topic(s):
General Literature
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Reference Links:
View the DOI record for Innovations in primary mental healthcare
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View the PubMed citation for Innovations in primary mental healthcare224
Integrated Behavioral Health in Pediatric Primary Care
Type: Journal Article
Year: 2016
Publication Place: United States
Abstract: There are multiple barriers to accessing high quality, evidence-based behavioral health care for children and adolescents, including stigma, family beliefs, and the significant paucity of child and adolescent psychiatrists. Although equal access continues to be an unmet need in the USA, there is growing recognition that integrated behavioral health services in pediatric primary care have the potential to reduce health disparities and improve service utilization. In a joint position paper, the American Academy of Pediatrics (AAP) and the American Academy of Child and Adolescent Psychiatry (AACAP) highlighted the multiple benefits of children receiving initial behavioral health screening, assessment, and evidence-based behavioral health treatments in the medical home. The purpose of this paper is to review the current state of the literature related to integrated behavioral health services in pediatric primary care. Specifically, innovative models of integrated behavioral health care are discussed.
Topic(s):
Healthcare Disparities
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Reference Links: View the PubMed citation for Integrated Behavioral Health in Pediatric Primary Care
225
Integrated care for pregnant women on methadone maintenance treatment: Canadian primary care cohort study
Type: Journal Article
Year: 2013
Publication Place: Canada
Abstract: OBJECTIVE: To describe the characteristics of a national cohort of pregnant women on methadone maintenance treatment (MMT) and to provide treatment outcome data for integrated care programs. DESIGN: Retrospective chart review. SETTING: Three different integrated care programs in geographically distinct cities: the Toronto Centre for Substance Use in Pregnancy in Toronto, Ont; the Herzl Family Practice Centre in Montreal, Que; and the Sheway clinic in Vancouver, BC. PARTICIPANTS: Pregnant women meeting criteria for opioid dependence and attending an integrated care program between 1997 and 2009. Women were excluded if they were on MMT only for chronic pain. MAIN OUTCOME MEASURES: Patient demographic characteristics, concurrent medical and psychiatric disorders, and substance use outcome data. RESULTS: A total of 102 opioid-dependent pregnancies were included. The mean age was 29.7 years and 64% of women were white. Women in Montreal were more likely to have partners and had fewer children. Differences in living and housing situations among the sites tended to resolve by the time of delivery. Almost half of this cohort tested positive for hepatitis C. Women had a high prevalence of depression and anxiety across all sites. Half of this cohort was on MMT before conception and for the other half, MMT was initiated at a mean gestational age of 20.7 weeks, resulting in a mean dose of 82.4 mg at delivery. At the first visit, polysubstance use was common. Prescription opioid use was more frequent in Toronto and heroin use was more prevalent in Vancouver and Montreal. For the entire population, significant reductions were found by the time of delivery for illicit (P < .001) and prescription opioids (P = .001), cocaine (P < .001), marijuana (P = .009), and alcohol use (P < .001). CONCLUSION: Despite geographic differences, all 3 integrated care programs have been associated with significant decreases in substance use in pregnant opioid-dependent women.
Topic(s):
Healthcare Disparities
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Reference Links: View the PubMed citation for Integrated care for pregnant women on methadone maintenance treatment: Canadian primary care cohort study
226
Integrated care models for ADHD in children and adolescents: A systematic review
Type: Journal Article
Year: 2018
Publication Place: United States
Topic(s):
Medical Home
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Reference Links:
View the DOI record for Integrated care models for ADHD in children and adolescents: A systematic review
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View the PubMed citation for Integrated care models for ADHD in children and adolescents: A systematic review228
Integrated care: meeting mental health needs after the Gulf oil spill
Type: Journal Article
Year: 2014
Publication Place: United States
Abstract: This column describes an integrated behavioral health initiative in primary care clinics in Louisiana parishes affected by the Deepwater Horizon oil spill. The Louisiana Mental and Behavioral Health Capacity Project is an integral part of the Gulf Region Health Outreach Program and is funded from the Deepwater Horizon Medical Benefits Class Action Settlement. Using a public health approach, the Department of Psychiatry of the Louisiana State University Health Sciences Center developed an interprofessional collaboration model of care to provide culturally tailored and time-sensitive on-site and telemedicine services to adults and children affected by the disaster. Results indicate a high level of acceptance of the services and reductions in both mental health symptoms and general medical symptoms. Primary care clinic staff also report increased confidence and resilience to meet future disasters. The approach could be used by communities at risk of disasters and by rural communities with limited mental health resources.
Topic(s):
Healthcare Disparities
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Reference Links:
View the DOI record for Integrated care: meeting mental health needs after the Gulf oil spill
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View the PubMed citation for Integrated care: meeting mental health needs after the Gulf oil spill229
Integrated mental health care in a multidisciplinary maternal and child health service in the community: the findings from the Suzaka trial
Type: Journal Article
Year: 2019
Publication Place: England
Abstract: BACKGROUND: Perinatal mental health problems such as mood disorders are common. We propose a new multidisciplinary health service intervention program providing continuous support to women and their children from the start of pregnancy till after childbirth. The aim of this study was to examine the effects of the program with respect to making women's mental health better in the postpartum period and improving the state of care for women and their children in the perinatal period. METHODS: We performed a controlled study to investigate the effectiveness of the program in Suzaka City, Japan. The women's mental health status was assessed using the Edinburgh Postnatal Depression Scale (EPDS) 3 months postpartum. Of 349 women, 210 were allocated to the intervention group and 139 to the control group. From April 2014 to March 2015, the number of the pregnant women who were followed-up by the multidisciplinary meeting in the intervention and control groups were 60 and 4, respectively. In the same period, the number of the pregnant women who were identified as requiring intensive care were 21 and 2, respectively. RESULTS: The total EPDS score, which was the primary outcome of the present study, differed significantly between the intervention and control groups (Mean [SD] = 2.74 (2.89) and 4.58 [2.62], respectively; p < 0.001). The number of the women receiving counseling from a public health nurse (5.3% in intervention group, 0.7% in control group, p = 0.02), attending maternal seminars (attendant ratio: 46% whereas 16%, p = 0.01), and receiving home visits by public health nurses (home visit ratio: 93.8% whereas 82.6%, p < 0.001) was significantly higher in the intervention group compared to the control group. CONCLUSIONS: The present study indicates that continuum support provided by integrated mental health care through a multidisciplinary maternal and child health service in the community can make women's mental health better in the postpartum period and help women and their children receive more health services from public health nurses. TRIAL REGISTRATION: Name of registry: Research for the effectiveness of a multi-professional health service intervention program of continuum supports for mother and child which starts for pregnancy periods to enhance maternal mental health. UMIN Clinical Trials Registry number: UMIN000032424 . Registration date: April 29th, 2018. Registration timing: retrospective.
Topic(s):
Healthcare Disparities
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230
Integrated Mental Health Training Relates to Pediatric Residents' Confidence with Child Mental Health Disorders
Type: Journal Article
Year: 2020
Publication Place: United States
Abstract: OBJECTIVE: The primary aim of this study was to determine the association of an integrated mental health training model on pediatric residents' use of (1) secondary screens, (2) mental health referrals, (3) psychotropic medications, and (4) follow-up appointments for mental health concerns. The secondary aim was to determine resident confidence managing mental health conditions. METHODS: Visits of children ages 6-18 years old with either a positive primary mental health screen or a mental health diagnosis in pre- and post-intervention years (N = 113 and N = 251, respectively) at a single-site continuity clinic were included. Authors also surveyed alumni from pre- and post- intervention years (N = 46) about their confidence with managing mental health disorders. The authors used chi-squared and t-tests to compare visit characteristics between years and multivariable logistic regression to determine correlates of mental health management. RESULTS: Post-intervention residents more often used secondary screening tools (adjusted odds ratio 5.61, 95% confidence interval 2.08-15.17). There were no differences in referrals, prescribing psychotropic medications, or follow-up visits. Post-intervention graduates reported higher confidence with diagnosis, screening, medication management, and follow-up for mental health disorders. CONCLUSIONS: After transitioning to an integrated mental health model, residents were more likely to use secondary screens and post-intervention graduates reported higher confidence with managing mental health disorders.
Topic(s):
General Literature
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Reference Links:
View the DOI record for Integrated Mental Health Training Relates to Pediatric Residents' Confidence with Child Mental Health Disorders
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View the PubMed citation for Integrated Mental Health Training Relates to Pediatric Residents' Confidence with Child Mental Health Disorders231
Integrated Mental Health Training Relates to Pediatric Residents' Confidence with Child Mental Health Disorders
Type: Journal Article
Year: 2020
Publication Place: United States
Abstract: OBJECTIVE: The primary aim of this study was to determine the association of an integrated mental health training model on pediatric residents' use of (1) secondary screens, (2) mental health referrals, (3) psychotropic medications, and (4) follow-up appointments for mental health concerns. The secondary aim was to determine resident confidence managing mental health conditions. METHODS: Visits of children ages 6-18 years old with either a positive primary mental health screen or a mental health diagnosis in pre- and post-intervention years (N = 113 and N = 251, respectively) at a single-site continuity clinic were included. Authors also surveyed alumni from pre- and post- intervention years (N = 46) about their confidence with managing mental health disorders. The authors used chi-squared and t-tests to compare visit characteristics between years and multivariable logistic regression to determine correlates of mental health management. RESULTS: Post-intervention residents more often used secondary screening tools (adjusted odds ratio 5.61, 95% confidence interval 2.08-15.17). There were no differences in referrals, prescribing psychotropic medications, or follow-up visits. Post-intervention graduates reported higher confidence with diagnosis, screening, medication management, and follow-up for mental health disorders. CONCLUSIONS: After transitioning to an integrated mental health model, residents were more likely to use secondary screens and post-intervention graduates reported higher confidence with managing mental health disorders.
Topic(s):
General Literature
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Reference Links:
View the DOI record for Integrated Mental Health Training Relates to Pediatric Residents' Confidence with Child Mental Health Disorders
View DOI Record
View the PubMed citation for Integrated Mental Health Training Relates to Pediatric Residents' Confidence with Child Mental Health Disorders234
Integrated Primary Medical-Behavioral Health Care for Adolescent and Young Adult Depression: Predictors of Service Use in the Youth Partners in Care Trial
Type: Journal Article
Year: 2017
Publication Place: United States
Abstract: Objectives : Depression, a chronic and disabling condition, frequently has its first onset during adolescence, underscoring the value of early effective treatment and prevention. Integrated medical-behavioral health care provides one strategy for improving treatment access for adolescents and young adults (AYA). This study examined predictors of accessing treatment in a multisite randomized controlled trial evaluating an integrated collaborative care intervention aimed at improving access to evidence-based depression treatment through primary health care, compared with usual care. The integrated care intervention was able to overcome barriers to care associated with an initial reluctance to pursue active treatment and older age. Service use was low in both conditions among less acculturated/non-English-speaking families. Results support the value of integrated medical-behavioral health care for improving rates of care. Findings highlight mechanisms by which integrated care may lead to improved rates of care and outcomes for AYA, an underserved and understudied group.
Topic(s):
Education & Workforce
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, Healthcare Disparities
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236
Integrating Behavioral Health Care into an Urban Hospital-Based Pediatric Primary Care Setting
Type: Journal Article
Year: 2021
Abstract:
Integration of behavioral health into pediatric primary care clinics is a recommended practice with potential to address the mental health needs of underserved children. We describe our process of integrating a behavioral health team into our hospital-based pediatric practice that serves a low-income, ethnically diverse, and underserved population of children and youth in the southeastern U.S. We provide a summary of our four-year program evaluation of feasibility and acceptability of embedding a behavioral health team in our practice. We also discuss the challenges faced, including staff turnover and difficulty with billing for sustainability. Finally, we provide recommendations for pediatric clinics that seek to integrate behavioral health care into their practices.
Topic(s):
Education & Workforce
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, Financing & Sustainability
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, Healthcare Disparities
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Reference Links:
View the DOI record for Integrating Behavioral Health Care into an Urban Hospital-Based Pediatric Primary Care Setting
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View the PubMed citation for Integrating Behavioral Health Care into an Urban Hospital-Based Pediatric Primary Care Setting237
Integrating Children's Mental Health into Primary Care
Type: Journal Article
Year: 2016
Publication Place: United States
Topic(s):
Healthcare Disparities
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Reference Links: View the PubMed citation for Integrating Children's Mental Health into Primary Care
238
Integrating Evidence-Based Interventions for Adolescents Into Primary Care
Type: Journal Article
Year: 2015
Topic(s):
General Literature
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Reference Links:
View the DOI record for Integrating Evidence-Based Interventions for Adolescents Into Primary Care
View DOI Record
View the PubMed citation for Integrating Evidence-Based Interventions for Adolescents Into Primary Care239
Integrating primary care and behavioral health with four special populations: Children with special needs, people with serious mental illness, refugees, and deaf people
Type: Journal Article
Year: 2014
Publication Place: United States
Topic(s):
Healthcare Disparities
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