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The Literature Collection contains over 11,000 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).
952 Results
603
Parental help-seeking in primary care for child and adolescent mental health concerns: qualitative study
Type: Journal Article
Year: 2010
Publication Place: England
Abstract: BACKGROUND: Child and adolescent mental health problems are common in primary care. However, few parents of children with mental health problems express concerns about these problems during consultations. AIMS: To explore the factors influencing parental help-seeking for children with emotional or behavioural difficulties. METHOD: Focus group discussions with 34 parents from non-specialist community settings who had concerns about their child's mental health. All groups were followed by validation groups or semi-structured interviews. RESULTS: Most children had clinically significant mental health symptoms or associated impairment in function. Appointment systems were a key barrier, as many parents felt that short appointments did not allow sufficient time to address their child's difficulties. Continuity of care and trusting relationships with general practitioners (GPs) who validated their concerns were perceived to facilitate help-seeking. Parents valued GPs who showed an interest in their child and family situation. Barriers to seeking help included embarrassment, stigma of mental health problems, and concerns about being labelled or receiving a diagnosis. Some parents were concerned about being judged a poor parent and their child being removed from the family should they seek help. CONCLUSIONS: Primary healthcare is a key resource for children and young people with emotional and behavioural difficulties and their families. Primary care services should be able to provide ready access to health professionals with an interest in children and families and appointments of sufficient length so that parents feel able to discuss their mental health concerns.
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View the DOI record for Parental help-seeking in primary care for child and adolescent mental health concerns: qualitative study
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View the PubMed citation for Parental help-seeking in primary care for child and adolescent mental health concerns: qualitative study604
Participant perception of an integrated program for substance abuse in pregnancy
Type: Journal Article
Year: 2010
Publication Place: United States
Abstract: OBJECTIVE: To assess participant perception of an integrated model of care for substance abuse in pregnancy. DESIGN: Focus groups were employed for this qualitative study. SETTING: Two Family Medicine Units, 1 in Toronto and 1 in Montreal, where integrated care for licit and illicit substance abuse in pregnancy is provided by a team of doctors, nurses, nurse practitioners, and social workers. PARTICIPANTS: Women who had received addiction and prenatal care at 1 of the 2 sites. METHODS: Women were asked to discuss their experiences of care in focus groups. RESULTS: Five central themes emerged: judgment, physician-patient communication, team communication, support groups, and self-responsibility. CONCLUSION: Women felt more comfortable with provider teams that shared a consistent nonjudgmental attitude.
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View the DOI record for Participant perception of an integrated program for substance abuse in pregnancy
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View the PubMed citation for Participant perception of an integrated program for substance abuse in pregnancy609
Patient care complexity as perceived by primary care physicians
Type: Journal Article
Year: 2015
Publication Place: United States
Topic(s):
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View the DOI record for Patient care complexity as perceived by primary care physicians
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View the PubMed citation for Patient care complexity as perceived by primary care physicians610
Patient Engagement in ACO Practices and Patient-reported Outcomes Among Adults With Co-occurring Chronic Disease and Mental Health Conditions
Type: Journal Article
Year: 2018
Publication Place: United States
Abstract: BACKGROUND: Accountable care organizations (ACOs) have increased their use of patient activation and engagement strategies, but it is unknown whether they achieve better outcomes for patients with comorbid chronic physical and mental health conditions. OBJECTIVES: To assess the extent to which practices with patient-centered cultures, greater shared decision-making strategies, and better coordination among team members have better patient-reported outcomes (PROs) for patients with diabetes and/or cardiovascular and comorbid mental health diagnoses. RESEARCH DESIGN: Sixteen practices randomly selected from top and bottom quartiles of a 39-item patient activation/engagement implementation survey of primary care team members (n=411) to assess patient-centered culture, shared decision-making, and relational coordination among team members. These data were linked to survey data on patient engagement and on emotional, physical, and social patient-reported health outcomes. SUBJECTS: Adult patients (n=606) with diabetes, cardiovascular, and comorbid mental health conditions who had at least 1 visit at participating primary care practices of 2 ACOs. MEASURES: Depression/anxiety, physical functioning, social functioning; patient-centered culture, patient activation/engagement implementation, relational coordination. RESULTS: Patients receiving care from practices with high patient-centered cultures reported better physical functioning (0.025) and borderline better emotional functioning (0.059) compared with less patient-centered practices. More activated patients reported better PROs, with higher activation levels partially mediating the relationship of patient-centered culture and better PROs. CONCLUSIONS: ACO patients with comorbid physical and mental health diagnoses report better physical functioning when practices have patient-centered cultures. More activated/engaged patients report better patient emotional, physical, and social health outcomes.
Topic(s):
General Literature
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611
Patient Engagement in ACO Practices and Patient-reported Outcomes Among Adults With Co-occurring Chronic Disease and Mental Health Conditions
Type: Journal Article
Year: 2018
Publication Place: United States
Abstract: BACKGROUND: Accountable care organizations (ACOs) have increased their use of patient activation and engagement strategies, but it is unknown whether they achieve better outcomes for patients with comorbid chronic physical and mental health conditions. OBJECTIVES: To assess the extent to which practices with patient-centered cultures, greater shared decision-making strategies, and better coordination among team members have better patient-reported outcomes (PROs) for patients with diabetes and/or cardiovascular and comorbid mental health diagnoses. RESEARCH DESIGN: Sixteen practices randomly selected from top and bottom quartiles of a 39-item patient activation/engagement implementation survey of primary care team members (n=411) to assess patient-centered culture, shared decision-making, and relational coordination among team members. These data were linked to survey data on patient engagement and on emotional, physical, and social patient-reported health outcomes. SUBJECTS: Adult patients (n=606) with diabetes, cardiovascular, and comorbid mental health conditions who had at least 1 visit at participating primary care practices of 2 ACOs. MEASURES: Depression/anxiety, physical functioning, social functioning; patient-centered culture, patient activation/engagement implementation, relational coordination. RESULTS: Patients receiving care from practices with high patient-centered cultures reported better physical functioning (0.025) and borderline better emotional functioning (0.059) compared with less patient-centered practices. More activated patients reported better PROs, with higher activation levels partially mediating the relationship of patient-centered culture and better PROs. CONCLUSIONS: ACO patients with comorbid physical and mental health diagnoses report better physical functioning when practices have patient-centered cultures. More activated/engaged patients report better patient emotional, physical, and social health outcomes.
Topic(s):
General Literature
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612
Patient engagement with primary health care following discharge from community mental health services
Type: Journal Article
Year: 2014
Publication Place: New Zealand
Abstract: AIM: Increasing pressure is being placed to facilitate Community Mental Health (CMH) patients' discharge to primary care. However, engagement following discharge is an under-researched area. This audit aimed to measure engagement and explore the factors that are associated with engagement in primary care following discharge from CMH. METHOD: Primary care teams for 55 service users discharged from Auckland District Health Board CMH centres between July and December 2012 were approached as part of an audit and asked to provide information regarding engagement with general practitioners. RESULTS: From the 50 responses received, the median number of GP visits per year was 3.7 and the mean was 4.41. 72% of the sample had contact with their GP at least every 3-4 months, however 8% did not engage with their primary care team. Differences in attendance following discharge based on age, diagnosis or socioeconomic status were not found. There was a suggestion that where GPs had responsibility for ongoing prescribing individuals engaged more frequently. CONCLUSION: Generally, discharged individuals engage with their primary care team well, and at a level many clinicians would be comfortable with. There is a proportion of the population that does not engage at this level, which requires further study.
Topic(s):
General Literature
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Reference Links: View the PubMed citation for Patient engagement with primary health care following discharge from community mental health services
613
Patient experiences in behavioral health integrated primary care settings: the role of stigma in shaping patient outcomes over time
Type: Journal Article
Year: 2019
Publication Place: England
Abstract: Behavioral health integration (BHI) models seek to improve patient experience and outcomes by bridging physical and behavioral health services. Past BHI research has not focused on stigma in these settings, which has been previously found to impact patient engagement and outcomes. We surveyed patients over a two year period at 12 integrated clinics in Oregon using measures developed by a Patient Advisory Team. Over a quarter of respondents reported stigmatization (26.81%). Compared to non-stigmatized patients, those who reported stigma had five times the odds of reporting unmet health needs (OR=5.14, p<0.0001), three times the odds reporting issues accessing care (OR=2.93, p<0.0001), six times the odds reporting hassle to get care (OR=6.49, p<0.0001), and three times the odds of reporting poor communication between providers (OR=3.45, p<0.0001). After examining the interaction between stigmatization and time, we found that stigmatized patients had lower odds at year two of reporting unmet health needs (OR=0.68, p=0.0034), issues accessing care (OR=0.77, p=0.0400), hassle getting care (OR=0.57, p=0.0001), and poor provider communication (OR=0.77, p=0.0544). We found that stigma remained prevalent for patients seeking care in the integrated clinics studied despite integration. Systems should consider integration efforts and reducing stigmatizing experiences in tandem to truly improve patient outcomes.
Topic(s):
General Literature
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614
Patient outcomes associated with primary care behavioral health services: A systematic review
Type: Journal Article
Year: 2018
Publication Place: United States
Abstract: OBJECTIVE: This systematic review focused on Primary Care Behavioral Health (PCBH) services delivered under normal clinic conditions that included the patient outcomes of: 1) access/utilization of behavioral health services, 2) health status, and 3) satisfaction. METHOD: Following PRISMA guidelines, comprehensive database searches and rigorous coding procedures rendered 36 articles meeting inclusion criteria. The principle summary measures of odd ratios or Cohen's d effect sizes were reported. RESULTS: Due to significant limitations in the methodological rigor of reviewed studies, robust findings only emerged for healthcare utilization: PCBH is associated with shorter wait-times for treatment, higher likelihood of engaging in care, and attending a greater number of visits. Several small, uncontrolled studies report emerging evidence that functioning, depression, and anxiety improve overtime. There was no evidence of greater improvement in patient health status when PCBH was compared to other active treatments. The limited available evidence supports that patient satisfaction with PCBH services is high. CONCLUSIONS: The implementation of PCBH services is ahead of the science supporting the usefulness of these services. Patient outcomes for PCBH are weaker than outcomes for Collaborative Care. More rigorous investigations of patient outcomes associated with PCBH are needed to allow for optimization of services.
Topic(s):
General Literature
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Reference Links: View the PubMed citation for Patient outcomes associated with primary care behavioral health services: A systematic review
615
Patient perspectives of an integrated program of medical care and substance use treatment
Type: Journal Article
Year: 2014
Publication Place: United States
Abstract: The benefits of integrating primary care and substance use disorder treatment are well known, yet true integration is difficult. We developed and evaluated a team-based model of integrated care within the primary care setting for HIV-infected substance users and substance users at risk for contracting HIV. Qualitative data were gathered via focus groups and satisfaction surveys to assess patients' views of the program, evaluate key elements for success, and provide recommendations for other programs. Key themes related to preferences for the convenience and efficiency of integrated care; support for a team-based model of care; a feeling that the program requirements offered needed structure; the importance of counseling and education; and how provision of concrete services improved overall well-being and quality of life. For patients who received buprenorphine/naloxone for opioid dependence, this was viewed as a major benefit. Our results support other studies that theorize integrated care could be of significant value for hard-to-reach populations and indicate that having a clinical team dedicated to providing substance use disorder treatment, HIV risk reduction, and case management services integrated into primary care clinics has the potential to greatly enhance the ability to serve a challenging population with unmet treatment needs.
Topic(s):
General Literature
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View the DOI record for Patient perspectives of an integrated program of medical care and substance use treatment
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View the PubMed citation for Patient perspectives of an integrated program of medical care and substance use treatment619
Patient-centered mental health care: encouraging caregiver participation
Type: Journal Article
Year: 2010
Publication Place: United States
Abstract: Caregivers of patients with mental illness play a vital role caring for their loved ones, yet they may not always be fully included in the process of assessment and treatment. A patient-centered approach to treating persons with mental illness views caregivers as partners in providing care for the patient. This study sought to explore perceptions of caregivers of persons with mental illness regarding the care their loved ones receive and to illicit specific issues caregivers wish to communicate with professionals that could improve patient care. A modified nominal group technique exercise was conducted as part of a suicide prevention workshop. Participants completed a four-item questionnaire. Five main themes emerged the caregivers' perception that they need to be included in the mental health care of their loved one; concerns about the diagnosing process; communication with professionals; a desire for individualized, holistic treatment; and the need for information about services and resources for the caregiver and the patient. Findings are similar to studies that also sought to understand the perspectives of caregivers. Caregivers provide an invaluable resource for the patient with mental illness. Efforts to include caregivers would enhance the overall care provided to patients with mental illness.
Topic(s):
General Literature
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Reference Links: View the PubMed citation for Patient-centered mental health care: encouraging caregiver participation