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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).
883 Results
1
"Chaplains for well-being" in primary care: Analysis of the results of a retrospective study
Type: Journal Article
Year: 2015
Topic(s):
General Literature
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View the DOI record for "Chaplains for well-being" in primary care: Analysis of the results of a retrospective study
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View the PubMed citation for "Chaplains for well-being" in primary care: Analysis of the results of a retrospective study3
A behavioral weight-loss intervention in persons with serious mental illness
Type: Journal Article
Year: 2013
Publication Place: United States
Abstract: BACKGROUND: Overweight and obesity are epidemic among persons with serious mental illness, yet weight-loss trials systematically exclude this vulnerable population. Lifestyle interventions require adaptation in this group because psychiatric symptoms and cognitive impairment are highly prevalent. Our objective was to determine the effectiveness of an 18-month tailored behavioral weight-loss intervention in adults with serious mental illness. METHODS: We recruited overweight or obese adults from 10 community psychiatric rehabilitation outpatient programs and randomly assigned them to an intervention or a control group. Participants in the intervention group received tailored group and individual weight-management sessions and group exercise sessions. Weight change was assessed at 6, 12, and 18 months. RESULTS: Of 291 participants who underwent randomization, 58.1% had schizophrenia or a schizoaffective disorder, 22.0% had bipolar disorder, and 12.0% had major depression. At baseline, the mean body-mass index (the weight in kilograms divided by the square of the height in meters) was 36.3, and the mean weight was 102.7 kg (225.9 lb). Data on weight at 18 months were obtained from 279 participants. Weight loss in the intervention group increased progressively over the 18-month study period and differed significantly from the control group at each follow-up visit. At 18 months, the mean between-group difference in weight (change in intervention group minus change in control group) was -3.2 kg (-7.0 lb, P=0.002); 37.8% of the participants in the intervention group lost 5% or more of their initial weight, as compared with 22.7% of those in the control group (P=0.009). There were no significant between-group differences in adverse events. CONCLUSIONS: A behavioral weight-loss intervention significantly reduced weight over a period of 18 months in overweight and obese adults with serious mental illness. Given the epidemic of obesity and weight-related disease among persons with serious mental illness, our findings support implementation of targeted behavioral weight-loss interventions in this high-risk population. (Funded by the National Institute of Mental Health; ACHIEVE ClinicalTrials.gov number, NCT00902694.).
Topic(s):
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View the DOI record for A behavioral weight-loss intervention in persons with serious mental illness
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View the PubMed citation for A behavioral weight-loss intervention in persons with serious mental illness5
A broad diagnostic framework to simplify the approach to mental disorders in primary care
Type: Journal Article
Year: 2014
Publication Place: South Africa
Abstract: Overemphasis on detailed classification of a psychiatic disorder at a primary level assessment may be unhelpful and prone to error. True rigour demands a continuous process of hypothesis formation that guides further enquiry. A simple categorisation of priority conditions provides a useful framework for a process. This approach has been set out by the World Health Organization (WHO) Mental Health Gap Action Program (MHGAP) Intervention Guide, which can then be adapted for use in the South African context. This then provides the basis for further enquiry and risk assessment at the initial consultation.
Topic(s):
General Literature
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Reference Links: View the PubMed citation for A broad diagnostic framework to simplify the approach to mental disorders in primary care
6
A case study of early experience with implementation of collaborative care in the Veterans Health Administration
Type: Journal Article
Year: 2010
Publication Place: United States
Abstract: Primary care remains critically important for those who suffer from mental disorders. Although collaborative care, which integrates mental health services into primary care, has been shown to be more effective than usual care, its implementation has been slow and the experience of providers and patients with collaborative care is less well known. The objective of this case study was to examine the effects of collaborative care on patient and primary care provider (PCP) experiences and communication during clinical encounters. Participating physicians completed a self-administered visit reconstruction questionnaire in which they logged details of patient visits and described their perceptions of the visits and the influence of collaborative care. Audio recordings of visits were analyzed to assess the extent of discussion about colocated mental health services and visit time devoted to mental health topics. The main outcome measures were the extent of discussion and recommendation for collaborative care during clinical visits and providers' experiences based on their responses to the visit reconstruction questionnaire. Providers surveyed expressed enthusiasm about collaborative care and cited the time constraint of office visits and lack of specialty support as the main reasons for limiting their discussion of mental health topics with patients. Despite the availability of mental health providers at the same clinic, PCPs missed many opportunities to address mental health issues with their patients. Ongoing education for PCPs regarding how to conduct a "warm handoff" to colocated providers will need to be an integral part of the implementation of collaborative care.
Topic(s):
General Literature
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View the DOI record for A case study of early experience with implementation of collaborative care in the Veterans Health Administration
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View the PubMed citation for A case study of early experience with implementation of collaborative care in the Veterans Health Administration7
A clinical psychologist in GP-Land: an evaluation of brief psychological interventions in primary care
Type: Journal Article
Year: 2014
Publication Place: New Zealand
Abstract: AIM: To evaluate the clinical outcomes and other impacts of brief therapy provided in a primary care setting by a clinical psychologist who was mainly employed in secondary mental health. METHOD: The outcomes of 23 primary care patients referred to a clinical psychologist were evaluated using the General Health Questionnaire (GHQ), the World Health Organisation Quality of Life (WHOQoL) scale, and the Beck Depression Inventory (BDI). A mixture of quantitative and qualitative data from patients and staff were analysed to identify other impacts of the intervention. RESULTS: Large improvements in BDI, GHQ, and WHOQOL scores were found, with strong changes consistent with the targets of the intervention. Patients reported primary-based clinical psychology input was more convenient and many engaged who had resisted referral to secondary mental health services. Other benefits to the service, including improved primary-secondary service integration, improved primary management of mental health difficulties, and improved liaison with mental health specialists, were reported by primary health staff. CONCLUSION: Brief psychological interventions by a visiting clinical psychologist in a general practice setting had substantial benefits for the patients and for the practice. This project indicates the value of integrated psychological input consistent with recent moves to better primary-secondary integration in mental health care.
Topic(s):
General Literature
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Reference Links: View the PubMed citation for A clinical psychologist in GP-Land: an evaluation of brief psychological interventions in primary care
8
A Comparison of Collaborative Care Outcomes in Two Health Care Systems: VA Clinics and Federally Qualified Health Centers
Type: Journal Article
Year: 2018
Abstract: OBJECTIVE: Collaborative care for depression results in symptom reduction when compared with usual care. No studies have systematically compared collaborative care outcomes between veterans treated at Veterans Affairs (VA) clinics and civilians treated at publicly funded federally qualified health centers (FQHCs) after controlling for demographic and clinical characteristics. METHODS: Data from two randomized controlled trials that used a similar collaborative care intervention for depression were combined to conduct post hoc analyses (N=759). The Telemedicine-Enhanced Antidepressant Management intervention was delivered in VA community-based outpatient clinics (CBOCs), and the Outreach Using Telemedicine for Rural Enhanced Access in Community Health intervention was delivered in FQHCs. Multivariate logistic regression was used to determine whether veteran status moderated the effect of the intervention on treatment response (>50% reduction in symptoms). RESULTS: There was a significant main effect for intervention (odds ratio [OR]=5.23, p<.001) and a moderating effect for veteran status, with lower response rates among veterans compared with civilians (OR=.21, p=.01). The addition of variables representing medication dosage and number of mental health and general health appointments did not influence the moderating effect. A sensitivity analysis stratified by gender found a significant moderating effect of veteran status for men but not women. CONCLUSIONS: Veteran status was a significant moderator of collaborative care effectiveness for depression, indicating that veterans receiving collaborative care at a CBOC are at risk of nonresponse. Unmeasured patient- or system-level characteristics may contribute to poorer response among veterans.
Topic(s):
General Literature
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9
A Conceptual Framework for Integrated Community Care
Type: Journal Article
Year: 2021
Topic(s):
General Literature
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11
A high physical symptom count reduces the effectiveness of treatment for depression, independently of chronic medical conditions
Type: Journal Article
Year: 2013
Topic(s):
General Literature
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13
A mental health brief intervention in primary care: does it work?
Type: Journal Article
Year: 2012
Publication Place: United States
Abstract: An onsite adjunctive service appears to improve the care of patients with mental health disorders.
Topic(s):
General Literature
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Reference Links: View the PubMed citation for A mental health brief intervention in primary care: does it work?
14
A Mixed-method Evaluation of the Behavioral Health Integration and Complex Care Initiative Using the Consolidated Framework for Implementation Research
Type: Journal Article
Year: 2021
Topic(s):
General Literature
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16
A multidisciplinary primary care team consultation in a socio-economically deprived community: an exploratory randomised controlled trial
Type: Journal Article
Year: 2011
Publication Place: England
Abstract: BACKGROUND: Psychosocial problems in socioeconomically deprived communities are not always amenable to traditional medical approaches. Mothers living in these areas are a particularly vulnerable group. The objective of this study was to evaluate the effectiveness of a lengthened multi-disciplinary team consultation in primary care in reducing anxiety and depression in mothers. METHODS: This was a prospective randomised controlled trial of a multidisciplinary team consultation against normal care. 94 mothers were recruited from three general practices from an area of extreme socio-economic deprivation. Mothers randomised into the intervention group attended a multidisciplinary consultation with up to four case-specific health care professionals. Consultations addressed medical, psychological and social problems and lasted up to one hour. Conventional primary care continued to be available to the intervention families. Control group families received normal primary care services. The outcomes measured were anxiety and depression as using the Hospital Anxiety and Depression Scale (HADS), health status using SF36v2, and quality of life using the abbreviated Schedule for the Evaluation of Individual Quality of Life (SEIQoL-DW) at baseline, 6 months and 12 months. RESULTS: Ordered logistic regression was used to analyse the data. There was no significant difference found between intervention and control groups after 6 months and 12 months in all of the measured outcomes. CONCLUSIONS: The new lengthened multi-disciplinary team consultation did not have any impact on the mental health, general health, and quality of life of mothers after 6 and 12 months. Other methods of primary health care delivery in socio-economically deprived communities need to be evaluated.
Topic(s):
General Literature
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17
A new era of collaboration for primary care and psychiatry
Type: Journal Article
Year: 2014
Publication Place: United States
Topic(s):
General Literature
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Reference Links: View the PubMed citation for A new era of collaboration for primary care and psychiatry
18
A nurse-facilitated depression screening program in an Army primary care clinic: an evidence-based project
Type: Journal Article
Year: 2010
Publication Place: United States
Abstract: BACKGROUND: Depression, sometimes with suicidal manifestations, is a medical condition commonly seen in primary care clinics. Routine screening for depression and suicidal ideation is recommended of all adult patients in the primary care setting because it offers depressed patients a greater chance of recovery and response to treatment, yet such screening often is overlooked or omitted. OBJECTIVE: The purpose of this study was to develop, to implement, and to test the efficacy of a systematic depression screening process to increase the identification of depression in family members of active duty soldiers older than 18 years at a military family practice clinic located on an Army infantry post in the Pacific. METHODS: The Iowa Model of Evidence-Based Practice to Promote Quality Care was used to develop a practice guideline incorporating a decision algorithm for nurses to screen for depression. A pilot project to institute this change in practice was conducted, and outcomes were measured. RESULTS: Before implementation, approximately 100 patients were diagnosed with depression in each of the 3 months preceding the practice change. Approximately 130 patients a month were assigned a 311.0 Code 3 months after the practice change, and 140 patients per month received screenings and were assigned the correct International Classification of Diseases, Ninth Revision Code 311.0 at 1 year. The improved screening and coding for depression and suicidality added approximately 3 minutes to the patient screening process. The education of staff in the process of screening for depression and correct coding coupled with monitoring and staff feedback improved compliance with the identification and the documentation of patients with depression. Nurses were more likely than primary care providers to agree strongly that screening for depression enhances quality of care. DISCUSSION: Data gathered during this project support the integration of military and civilian nurse-facilitated screening for depression in the military primary care setting. The decision algorithm should be adapted and tested in other primary care environments.
Topic(s):
General Literature
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View the DOI record for A nurse-facilitated depression screening program in an Army primary care clinic: an evidence-based project
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View the PubMed citation for A nurse-facilitated depression screening program in an Army primary care clinic: an evidence-based project19
A pilot study of a brief group adaptation of the Unified Protocol in integrated primary care
Type: Journal Article
Year: 2020
Publication Place: United States
Topic(s):
General Literature
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View the DOI record for A pilot study of a brief group adaptation of the Unified Protocol in integrated primary care
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View the PubMed citation for A pilot study of a brief group adaptation of the Unified Protocol in integrated primary care20
A plan to align substance abuse, mental health and primary care efforts in Minnesota
Type: Journal Article
Year: 2013
Publication Place: United States
Topic(s):
General Literature
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Reference Links: View the PubMed citation for A plan to align substance abuse, mental health and primary care efforts in Minnesota