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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
121
Coordinating Mental Health Care Across Primary Care and Schools: ADHD as a Case Example
Type: Journal Article
Year: 2013
Abstract: Although primary care practices and schools are major venues for the delivery of mental health services to children, these systems are disconnected, contributing to fragmentation in service delivery. This paper describes barriers to collaboration across the primary care and school systems, including administrative and fiscal pressures, conceptual and linguistic differences between healthcare and educational professionals, role restrictions among professionals, and privacy laws. Strategies for overcoming these barriers that can be applied in both primary care and school settings are described. The paper has a primary focus on children with ADHD, but the principles and strategies described are applicable to children with a range of mental health and health conditions.
Topic(s):
Education & Workforce
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, Healthcare Disparities
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Reference Links: 
View the DOI record for Coordinating Mental Health Care Across Primary Care and Schools: ADHD as a Case Example
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View the PubMed citation for Coordinating Mental Health Care Across Primary Care and Schools: ADHD as a Case Example122
CRAFFT as a Substance Use Screening Instrument for Adolescent Psychiatry Admissions
Type: Journal Article
Year: 2015
Publication Place: United States
Abstract: BACKGROUND: Adolescent use of alcohol and illicit substances is quite common among pediatric psychiatry inpatients; however, little data exist on substance use screening instruments that can be used to augment thorough psychiatric diagnostic interviews. CRAFFT is a screening tool for adolescent substance use that has been validated in outpatient general medical settings. This is the first study to examine its use in adolescent psychiatric inpatients. METHODS: We performed a chart review of records from adolescents admitted to our inpatient psychiatric unit who completed a CRAFFT screen on admission. We compared CRAFFT scores with other measures of substance use, including urine drug screens and the diagnosis of a substance use disorder at discharge. We also examined measures of depression and suicidality in individuals with elevated CRAFFT scores (>/=2 positive answers out of 6) and compared them with measures in those with normal CRAFFT scores. RESULTS: Elevated CRAFFT scores were correlated with other measures of alcohol and substance use, including the diagnosis of a substance use disorder at discharge (P<0.0001), and laboratory screening for alcohol (P=0.0048) and marijuana (P<0.0001) on admission. Previous suicide attempts (P=0.005) and "psychiatric trauma" (P=0.0027) were also positively associated with elevated CRAFFT scores. CONCLUSIONS: CRAFFT scores in adolescent inpatients were correlated with other measures of substance use, supporting its efficacy as a screening tool in this population. CRAFFT scores were also positively correlated with a history of psychiatric trauma and past suicide attempts, which is consistent with the results of previous studies associating pediatric substance use and traumatic life events with an increased risk of suicide.
Topic(s):
Opioids & Substance Use
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, Healthcare Disparities
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, Measures
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Reference Links:
View the DOI record for CRAFFT as a Substance Use Screening Instrument for Adolescent Psychiatry Admissions
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View the PubMed citation for CRAFFT as a Substance Use Screening Instrument for Adolescent Psychiatry Admissions125
Depression and Health Risk Behaviors: Towards Optimizing Primary Care Service Strategies for Addressing Risk
Type: Journal Article
Year: 2014
Abstract: PURPOSE: Depression and health risk behaviors in adolescents are leading causes of preventable morbidity and mortality. Primary care visits provide prime opportunities to screen and provide preventive services addressing risk behaviors/conditions. This study evaluated the co-occurrence of depression and health risk behaviors (focusing on smoking, drug and alcohol misuse, risky sexual behavior, and obesity-risk) with the goal of informing preventive service strategies. METHODS: Consecutive primary care patients (n=217), ages 13 to 18 years, selected to over-sample for depression, completed a Health Risk Behavior Survey and the Diagnostic Interview Schedule for Children and Adolescents (DISC) depression module. RESULTS: Youths with DISC-defined past-year depression were significantly more likely to report risk across multiple risk-areas, Wald X2(1)=14.39, p<.001, and to have significantly higher rates of past-month smoking, X2(1)=5.86, p=.02, substance misuse, X2(1)=15.12, p<.001, risky sex, X2 (1) =5.04, p=.03, but not obesity-risk, X2 (1) =0.19, p=.66. Cross-sectional predictors of risk behaviors across risk areas were similar. Statistically significant predictors across all risk domains included: youths' expectancies about future risk behavior; attitudes regarding the risk behavior; and risk behaviors in peers/others in their environments. CONCLUSIONS: Depression in adolescents is associated with a cluster of health risk behaviors that likely contribute to the high morbidity and mortality associated with both depression and health risk behaviors. Consistent with the United States National Prevention Strategy (2011) and the focus on integrated behavioral and medical health care, results suggest the value of screening and preventive services using combination strategies that target depression and multiple areas of associated health risk.
Topic(s):
Healthcare Disparities
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, Opioids & Substance Use
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, Measures
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Reference Links: View the PubMed citation for Depression and Health Risk Behaviors: Towards Optimizing Primary Care Service Strategies for Addressing Risk
127
Depression screening and management among adolescents in primary care: factors associated with best practice
Type: Journal Article
Year: 2013
Publication Place: United States
Abstract: OBJECTIVE: To compare depression identification and management perceptions and practices between professions and disciplines in primary care and examine factors that increase the likelihood of administering a standardized depression screening instrument, asking about patients' depressive symptoms, and using best practice when managing depressed adolescents. METHODS: Data came from an online survey of clinicians in Minnesota (20% response rate). Analyses involved bivariate tests and linear regressions. RESULTS: The analytic sample comprised 260 family medicine physicians, 127 pediatricians, 96 family nurse practitioners, and 54 pediatric nurse practitioners. Overall, few differences emerged between physicians and nurse practitioners or family and pediatric clinicians regarding addressing depression among adolescents. Two factors associated with administering a standardized instrument included having clear protocols for follow-up after depression screening and feeling better prepared to address depression among adolescents. CONCLUSIONS: Enhancing clinicians' competence to address depression and developing postscreening protocols could help providers implement universal screening in primary care.
Topic(s):
Education & Workforce
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Reference Links:
View the DOI record for Depression screening and management among adolescents in primary care: factors associated with best practice
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View the PubMed citation for Depression screening and management among adolescents in primary care: factors associated with best practice128
Depression screening in adolescents in the United States: a national study of ambulatory office-based practice
Type: Journal Article
Year: 2014
Publication Place: United States
Topic(s):
Healthcare Disparities
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, Medical Home
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Reference Links:
View the DOI record for Depression screening in adolescents in the United States: a national study of ambulatory office-based practice
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View the PubMed citation for Depression screening in adolescents in the United States: a national study of ambulatory office-based practice129
Detection and Treatment of Mental Health Issues by Pediatric PCPs in New York State: An Evaluation of Project TEACH
Type: Journal Article
Year: 2015
Publication Place: United States
Abstract: OBJECTIVE: The authors evaluated Project TEACH (PT), a statewide training and consultation program for pediatric primary care providers (PCPs) on identification and treatment of mental health conditions. METHODS: An intervention group of 176 PCPs who volunteered for PT training was compared with a stratified random sample of 200 PCPs who did not receive PT training. Data on prescription practices, diagnoses, and follow-up care were from New York State Medicaid files (2009-2013) for youths seen by the trained (N=21,784) and untrained (N=46,607) PCPs. RESULTS: The percentage of children prescribed psychotropic medication increased after PT training (9% to 12%, p<.001), a larger increase than in the untrained group (4% to 5%, p<.001) (comparison, p<.001). Fewer differences were noted in diagnoses and in medication use and follow-up care among children with depression. CONCLUSIONS: This intervention may have an impact on providers' behaviors, but further research is needed to clarify its effectiveness.
Topic(s):
Education & Workforce
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Reference Links:
View the DOI record for Detection and Treatment of Mental Health Issues by Pediatric PCPs in New York State: An Evaluation of Project TEACH
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View the PubMed citation for Detection and Treatment of Mental Health Issues by Pediatric PCPs in New York State: An Evaluation of Project TEACH136
Developmentally and culturally appropriate screening in primary care: development of the behavioral health checklist
Type: Journal Article
Year: 2013
Publication Place: United States
Abstract: OBJECTIVE: To evaluate the construct validity of the Behavioral Health Checklist (BHCL) for children aged from 4 to 12 years from diverse backgrounds. METHOD: The parents of 4-12-year-old children completed the BHCL in urban and suburban primary care practices affiliated with a tertiary-care children's hospital. Across practices, 1,702 were eligible and 1,406 (82.6%) provided consent. Children of participating parents were primarily non-Hispanic black/African American and white/Caucasian from low- to middle-income groups. Confirmatory factor analyses examined model fit for the total sample and subsamples defined by demographic characteristics. RESULTS: The findings supported the hypothesized 3-factor structure: Internalizing Problems, Externalizing Problems, and Inattention/Hyperactivity. The model demonstrated adequate to good fit across age-groups, gender, races, income groups, and suburban versus urban practices. CONCLUSION: The findings provide strong evidence of the construct validity, developmental appropriateness, and cultural sensitivity of the BHCL when used for screening in primary care.
Topic(s):
Healthcare Disparities
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Reference Links:
View the DOI record for Developmentally and culturally appropriate screening in primary care: development of the behavioral health checklist
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View the PubMed citation for Developmentally and culturally appropriate screening in primary care: development of the behavioral health checklist138
Disparities in unmet need for mental health services in the United States, 1997-2010
Type: Journal Article
Year: 2013
Publication Place: United States
Abstract: OBJECTIVES This study estimated unmet need for mental health services, identified population risk factors related to unmet need, and established baseline data to assess the impact of the Affordable Care Act (ACA) and the Mental Health Parity and Addiction Equity Act. METHODS National Health Interview Survey data (1997-2010) were analyzed. RESULTS Unmet need increased from 4.3 million in 1997 to 7.2 million in 2010. Rates in 2010 were about five times higher for uninsured than for privately insured persons. In a multivariate logistic model, likelihood was higher among children (age two to 17), working-age adults (age 18-64), women, uninsured persons, persons with low incomes, in fair or poor health, and with chronic conditions. CONCLUSIONS Unmet need is widespread, particularly among the uninsured. Expansion of coverage under the ACA, in conjunction with federal parity, should improve access, but ongoing monitoring of access is a research and policy priority.
Topic(s):
Healthcare Disparities
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, Healthcare Policy
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, Financing & Sustainability
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Reference Links:
View the DOI record for Disparities in unmet need for mental health services in the United States, 1997-2010
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View the PubMed citation for Disparities in unmet need for mental health services in the United States, 1997-2010140
Doctor-office collaborative care for pediatric behavioral problems: a preliminary clinical trial
Type: Journal Article
Year: 2012
Publication Place: United States
Abstract: OBJECTIVES: To evaluate the feasibility and clinical benefits of an integrated mental health intervention (doctor-office collaborative care [DOCC]) vs enhanced usual care (EUC) for children with behavioral problems. DESIGN: Cases were assigned to DOCC and EUC using a 2:1 randomization schedule that resulted in 55 DOCC and 23 EUC cases. SETTING: Preassessment was conducted in 4 pediatric primary care practices. Postassessment was conducted in the pediatric or research office. Doctor-office collaborative care was provided in the practice; EUC was initiated in the office but involved a facilitated referral to a local mental health specialist. PARTICIPANTS: Of 125 referrals (age range, 5-12 years), 78 children participated. INTERVENTIONS: Children and their parents were assigned to receive DOCC or EUC. MAIN OUTCOME MEASURES: Preassessment diagnostic status was evaluated using the Schedule for Affective Disorders and Schizophrenia for School-aged Children. Preassessment and 6-month postassessment ratings of behavioral and emotional problems were collected from parents using the Vanderbilt Attention-Deficit/Hyperactivity Disorder Diagnostic Parent Rating Scale, as well as individualized goal achievement ratings forms. At discharge, care managers and a diagnostic evaluator completed the Clinical Global Impression Scale, and pediatricians and parents completed satisfaction and study feedback measures. RESULTS: Group comparisons found significant improvements for DOCC over EUC in service use and completion, behavioral and emotional problems, individualized behavioral goals, and overall clinical response. Pediatricians and parents were highly satisfied with DOCC. CONCLUSION: The feasibility and clinical benefits of DOCC for behavioral problems support the integration of collaborative mental health services for common mental disorders in primary care.
Topic(s):
HIT & Telehealth
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Reference Links:
View the DOI record for Doctor-office collaborative care for pediatric behavioral problems: a preliminary clinical trial
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View the PubMed citation for Doctor-office collaborative care for pediatric behavioral problems: a preliminary clinical trial