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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).
897 Results
822
The role of primary care in service provision for people with severe mental illness in the United kingdom
Type: Journal Article
Year: 2012
Publication Place: United States
Abstract: BACKGROUND: Severe mental illness is a serious and potentially life changing set of conditions. This paper describes and analyses patient characteristics and service usage over one year of a representative cohort of people with a diagnosis of severe mental illness across England, including contacts with primary and secondary care and continuity of care. METHODS AND FINDINGS: Data were collected from primary care patient notes (n = 1150) by trained nurses from 64 practices in England, covering all service contacts from 1(st) April 2008 to 31st March 2009. The estimated national rate of patients seen only in primary care in the period was 31.1% (95% C.I. 27.2% to 35.3%) and the rates of schizophrenia and bipolar disorder were 56.8% (95% C.I. 52.3% to 61.2%) and 37.9% (95% C.I. 33.7% to 42.2%). In total, patients had 7,961 consultations within primary care and 1,993 contacts with mental health services (20% of the total). Unemployed individuals diagnosed more recently were more likely to have contact with secondary care. Of those seen in secondary care, 61% had at most two secondary care contacts in the period. Median annual consultation rates with GPs were lower than have been reported for previous years and were only slightly above the general population. Relational continuity in primary care was poor for 21% of patients (Modified Modified Continuity Index = <0.5), and for almost a third of new referrals to mental health services the primary care record contained no information on the referral outcome. CONCLUSIONS: Primary care is centrally involved in the care of people with serious mental illness, but primary care and cross-boundary continuity is poor for a substantial proportion. Research is needed to determine the impact of poor continuity on patient outcomes, and above all, the impact of new collaborative ways of working at the primary/secondary care interface.
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View the DOI record for The role of primary care in service provision for people with severe mental illness in the United kingdom
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View the PubMed citation for The role of primary care in service provision for people with severe mental illness in the United kingdom823
The role of primary care in the recognition of and response to dementia
Type: Journal Article
Year: 2010
Publication Place: France
Topic(s):
General Literature
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View the PubMed citation for The role of primary care in the recognition of and response to dementia
Reference Links: View the PubMed citation for The role of primary care in the recognition of and response to dementia
825
The role of psychotherapy in integrated care
Type: Journal Article
Year: 2014
Publication Place: United States
Abstract: The current emphasis on integrated psychiatric and medical care for people with mental illnesses raises hopes for more favorable clinical outcomes as well as concerns about the quality of the actual care being delivered. The author writes from the perspective of a long career as a psychiatrist and psychoanalyst in a full service medical building in which communication and, at times, collaboration between mental health and general health providers yielded significant benefits to patients. Psychotherapy played a major role in these favorable outcomes, as did accessibility to general medical services when needed and working relationships between physicians of different specialties. However, conditions in current integrated systems pose seemingly insurmountable obstacles to offering full service psychiatric care. The overwhelming disproportion between the numbers of patients in serious need and the available psychiatric resources creates wrenching clinical dilemmas. The hard-nosed administrative approaches to the challenge appear to leave out the factors of human relationships and the conditions necessary for effective psychotherapy beyond simple triage and ultra-brief supportive therapy in crises. Where it is possible for psychiatrists to work closely with other physicians, certain conditions are necessary to maintain the integrity of the psychotherapeutic relationship and the psychiatrist's psychotherapeutic skills.
Topic(s):
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826
The South West Local Health Integration Network Behavioural Supports Ontario Experience
Type: Journal Article
Year: 2016
Publication Place: Canada
Abstract: Creating a seamless system of care with improved system and patient outcomes is imperative to the estimated 35,000 older adults living with mental health problems and addictions in the South West Local Health Integration Network. Building on existing investments and those offered through the Behavioural Supports Ontario program, strategies to improve system coordination were put in place, cross-sectoral partnerships were fostered, interdisciplinary teams from across the care continuum were linked, and educational opportunities were promoted. This evolving, co-created system has resulted in a decrease in alternate level of care cases among those with behavioural specialized needs and improved client/family perceptions of care. Also, in fiscal year 2014/15, it provided more than 7,000 care providers with learning opportunities.
Topic(s):
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Reference Links: View the PubMed citation for The South West Local Health Integration Network Behavioural Supports Ontario Experience
828
The symptom cluster-based approach to individualize patient-centered treatment for major depression
Type: Journal Article
Year: 2014
Publication Place: United States
Abstract: Unipolar major depressive disorder is a common, disabling, and costly disease that is the leading cause of ill health, early death, and suicide in the United States. Primary care doctors, in particular family physicians, are the first responders in this silent epidemic. Although more than a dozen different antidepressants in 7 distinct classes are widely used to treat depression in primary care, there is no evidence that one drug is superior to another. Comparative effectiveness studies have produced mixed results, and no specialty organization has published recommendations on how to choose antidepressants in a rational, evidence-based manner. In this article we present the theory and evidence for an individualized, patient-centered treatment model for major depression designed around a targeted symptom cluster-based approach to antidepressant selection. When using this model for healthy adults with major depressive disorder, the choice of antidepressants should be guided by the presence of 1 of 4 common symptom clusters: anxiety, fatigue, insomnia, and pain. This model was built to foster future research, provide a logical framework for teaching residents how to select antidepressants, and equip primary care doctors with a structured treatment strategy to deliver optimal patient-centered care in the management of a debilitating disease: major depressive disorder.
Topic(s):
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View the DOI record for The symptom cluster-based approach to individualize patient-centered treatment for major depression
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View the PubMed citation for The symptom cluster-based approach to individualize patient-centered treatment for major depression830
The tri-optic: Next step for Collaborative Family Health Care
Type: Journal Article
Year: 2015
Publication Place: United States
Topic(s):
General Literature
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View the DOI record for The tri-optic: Next step for Collaborative Family Health Care
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View the PubMed citation for The tri-optic: Next step for Collaborative Family Health Care831
The unsettled baby: crying out for an integrated, multidisciplinary primary care approach
Type: Journal Article
Year: 2010
Publication Place: Australia
Abstract: Unsettled behaviour in the first few months of life is a common clinical problem, with the associated risks of postnatal depression, premature cessation of breastfeeding, long-term psychological disturbance, and child abuse. Parents of new babies complain of difficulty accessing appropriate care and receiving conflicting advice. Although organic disturbance is implicated in only 5% of cases, gastro-oesophageal reflux disease, food allergies and lactose intolerance are often mistakenly diagnosed in unsettled babies. There is no evidence that acid-suppressive medications help in treating unsettled behaviour and, until the hypothesis that proton-pump inhibitors may predispose to food allergies has been properly investigated, treatment with acid-suppressive medications should be avoided in this population. Although unsettled behaviour in infants is commonly a transient neurodevelopmental phenomenon that peaks at 6 weeks of age, failure to diagnose other correctable problems, including breastfeeding difficulty and cows milk allergy, risks entrenching anxiety and disrupted mother-infant interactions in the long term. In the current climate of health system reform, the design and evaluation of an integrated, evidence-based, multidisciplinary primary care approach to management of unsettled babies and their mothers is a priority.
Topic(s):
General Literature
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Reference Links: View the PubMed citation for The unsettled baby: crying out for an integrated, multidisciplinary primary care approach
832
The work and challenges of care managers in the implementation of collaborative care: A qualitative study
Type: Journal Article
Year: 2018
Publication Place: England
Topic(s):
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View the DOI record for The work and challenges of care managers in the implementation of collaborative care: A qualitative study
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View the PubMed citation for The work and challenges of care managers in the implementation of collaborative care: A qualitative study834
Thoughts on improving integration. Interview by Lori Ascroft and William A Anthony
Type: Journal Article
Year: 2010
Publication Place: United States
Topic(s):
General Literature
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Reference Links: View the PubMed citation for Thoughts on improving integration. Interview by Lori Ascroft and William A Anthony
835
Time for a rethink of treatment for patients with depression in primary care
Type: Journal Article
Year: 2010
Publication Place: England
Topic(s):
General Literature
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View the DOI record for Time for a rethink of treatment for patients with depression in primary care
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View the PubMed citation for Time for a rethink of treatment for patients with depression in primary care837
Towards client-centered counseling: Development and testing of the WHO Decision-Making Tool
Type: Journal Article
Year: 2010
Publication Place: Ireland
Topic(s):
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View the DOI record for Towards client-centered counseling: Development and testing of the WHO Decision-Making Tool
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View the PubMed citation for Towards client-centered counseling: Development and testing of the WHO Decision-Making Tool838
Training peer educators to promote self-management skills in people with serious mental illness (SMI) and diabetes (DM) in a primary health care setting
Type: Journal Article
Year: 2014
Abstract: Aim To describe the training and participant experience of patients with both severe mental illness (SMI) and diabetes (DM) who were enrolled in a Peer Educator Training Program adapted to a primary health care setting. BACKGROUND: The mortality of patients with both SMI and DM is high. Illness self-management includes medications, psychosocial treatments, and healthy behaviors, yet treatment engagement is often sub-optimal with adherence rates of 52% for diabetic medications and 62% for antipsychotic medications among the SMI. To address this problem, a new behavioral intervention study targeting SMI and DM self-management used trained peer educators (PEs) with the same chronic conditions to enhance program effectiveness. A manual facilitated training on intervention topics such as SMI and DM therapies, stress management, and stigma reduction as well as training in group intervention techniques, telephone skills, and crisis management. METHODS: We assessed PE attitudes and input using in-depth face-to-face interviews. Interviews were audio-taped, transcribed, coded, and analyzed using the classic method of content analysis emphasizing dominant themes. A member check-in was conducted where participants commented on analysis results. Findings Six relevant descriptive themes emerged: (1) positive group experience; (2) success with learning manual content; (3) increased knowledge about SMI and DM; (4) improved self-management skills; (5) increased self-confidence and self-efficacy in becoming a PE; and being (6) united in purpose to help others self-manage their SMI and DM. Qualitative evidence supports structured training for SMI-DM PEs. Key components include written educational materials and the power of the group process to increase knowledge, self-management skills, confidence, and self-efficacy. Recommendations are offered to support further endeavors to mobilize peers with SMI to help other patients with complex comorbidities better manage their own health.
Topic(s):
General Literature
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839
Transdiagnostic stepped care in mental health
Type: Journal Article
Year: 2017
Publication Place: Australia
Abstract: A component of Australia's recent national reform agenda for mental health services is the directive to the Primary Health Networks to develop and implement stepped-care models of service delivery. The current guidance proposes that interventions are aligned to mild, moderate and severe illness categories. Other models in operation are tied to single disorders, such as depression. Both approaches have a number of limitations when applied to real-world, complex clinical practice, especially in primary care. This article outlines some limitations of these models and argues for the development of a transdiagnostic model, based on developments in our work in primary care youth services, which can be generalised to adult populations. Such models aim to ensure that consumers receive the right intensity of care at the right time. The adjunct use of technology within services could also improve service accessibility and outcomes monitoring, and help to improve the efficiency of resource allocation based on consumer need.
Topic(s):
General Literature
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840
Transdisciplinary care: opportunities and challenges for behavioral health providers
Type: Journal Article
Year: 2010
Publication Place: United States
Topic(s):
General Literature
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View the DOI record for Transdisciplinary care: opportunities and challenges for behavioral health providers
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View the PubMed citation for Transdisciplinary care: opportunities and challenges for behavioral health providers