Email UpdatesLiterature Collection
Collection Insights
11K+
References
9K+
Articles
1500+
Grey Literature
4600+
Opioids & SU
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).
11272 Results
3222
Does depression diagnosis and antidepressant prescribing vary by location? Analysis of ethnic density associations using a large primary-care dataset
Type: Journal Article
Year: 2016
Publication Place: England
Abstract: BACKGROUND: Studies have linked ethnic differences in depression rates with neighbourhood ethnic density although results have not been conclusive. We looked at this using a novel approach analysing whole population data covering just over one million GP patients in four London boroughs. METHOD: Using a dataset of GP records for all patients registered in Lambeth, Hackney, Tower Hamlets and Newham in 2013 we investigated new diagnoses of depression and antidepressant use for: Indian, Pakistani, Bangladeshi, black Caribbean and black African patients. Neighbourhood effects were assessed independently of GP practice using a cross-classified multilevel model. RESULTS: Black and minority ethnic groups are up to four times less likely to be newly diagnosed with depression or prescribed antidepressants compared to white British patients. We found an inverse relationship between neighbourhood ethnic density and new depression diagnosis for some groups, where an increase of 10% own-ethnic density was associated with a statistically significant (p < 0.05) reduced odds of depression for Pakistani [odds ratio (OR) 0.81, 95% confidence interval (CI) 0.70-0.93], Indian (OR 0.88, CI 0.81-0.95), African (OR 0.88, CI 0.78-0.99) and Bangladeshi (OR 0.94, CI 0.90-0.99) patients. Black Caribbean patients, however, showed the opposite effect (OR 1.26, CI 1.09-1.46). The results for antidepressant use were very similar although the corresponding effect for black Caribbeans was no longer statistically significant (p = 0.07). CONCLUSION: New depression diagnosis and antidepressant use was shown to be less likely in areas of higher own-ethnic density for some, but not all, ethnic groups.
Topic(s):
Healthcare Disparities
See topic collection
3226
Does incarceration influence patients' goals for opioid use disorder treatment? A qualitative study of buprenorphine treatment in jail
Type: Journal Article
Year: 2021
Publication Place: Ireland
Topic(s):
Healthcare Disparities
See topic collection
, Opioids & Substance Use
See topic collection
3228
Does integrated care improve treatment for depression? A systematic review
Type: Journal Article
Year: 2011
Publication Place: United States
Abstract: Care management-based interventions promoting integrated care by combining primary care with mental health services in a coordinated and colocated manner are increasingly popular; yet, the benefits of specific approaches are not well established. We conducted a systematic review of integrated care trials in US primary care settings to assess whether the level of integration of provider roles or care process affects clinical outcomes. Although most trials showed positive effects, the degree of integration was not significantly related to depression outcomes. Integrated care appears to improve depression management in primary care patients, but questions remain about its specific form and implementation.
Topic(s):
Key & Foundational
See topic collection
Reference Links: 
View the DOI record for Does integrated care improve treatment for depression? A systematic review
View DOI Record
View the PubMed citation for Does integrated care improve treatment for depression? A systematic review3229
Does Mental Health Care Integration Affect Primary Care Clinician Burnout? Results from a Longitudinal Veterans Affairs Survey
Type: Journal Article
Year: 2020
Abstract:
BACKGROUND: Burnout among primary care clinicians (PCPs) is associated with negative health and productivity consequences. The Veterans Health Administration (VA) embedded mental health specialists and care managers in primary care to manage common psychiatric diseases. While challenging to implement, mental health integration is a team-based care model thought to improve clinician well-being. OBJECTIVE: To examine the relationships between PCP-reported burnout (and secondarily, job satisfaction) and mental health integration at provider and clinic levels DESIGN: Analysis of 286 cross-sectional surveys in 2012 (n = 171) and 2013 (n = 115) PARTICIPANTS: 210 PCPs in one VA region MAIN MEASURES: Outcomes were PCP-reported burnout (Maslach Burnout Inventory emotional exhaustion subscale), and secondarily, job satisfaction. Two independent variables represented mental health integration: (1) PCP-specialty communication rating and (2) proportion of clinic patients who saw integrated specialists. Using multilevel regression models, we examined PCP-reported burnout (and job satisfaction) and mental health integration, adjusting for PCP characteristics (e.g., gender), PCP ratings of team functioning (communication, knowledge/skills, satisfaction), and organizational factors. KEY RESULTS: On average, PCPs reported high burnout (29, range = 9-54) across all VA healthcare systems. In total, 46% of PCPs reported "very easy" communication with mental health; 9% of primary clinic patients had seen integrated specialists. Burnout was not significantly associated with mental health communication ratings (β coefficient = - 0.96, standard error [SE] = 1.29, p = 0.46), nor with proportion of clinic patients who saw integrated specialists (β = 0.02, SE = 0.11, p = 0.88). No associations were observed with job satisfaction either. Among study participants, PCPs with poor team functioning, as exhibited by low team communication ratings, reported high burnout (β = - 1.28, SE = 0.22, p < 0.001) and low job satisfaction (β = 0.12, SE = 0.02, p < 0.001). CONCLUSIONS: As currently implemented, primary care and mental health integration did not appear to impact PCP-reported burnout, nor job satisfaction. More research is needed to explore care model variation among clinics in order to optimize implementation to enhance PCP well-being.
Topic(s):
Education & Workforce
See topic collection
, Healthcare Disparities
See topic collection
, Measures
See topic collection
3233
Does primary care mental health resourcing affect the use and costs of secondary psychiatric services?
Type: Journal Article
Year: 2014
Publication Place: Switzerland
Abstract: Collaborative care models for treatment of depression and anxiety disorders in primary care have been shown to be effective. The aim of this study was to investigate at the municipal level to what extent investment in mental health personnel at primary care health centres in the study area is reflected in the costs and use of secondary psychiatric services. Furthermore, we analysed whether the service provision and use of secondary psychiatric care correlates with the socioeconomic indicators of need. We found significant variation in the amount of mental health personnel provided at the health centres, uncorrelated with the indicators of need nor with the costs of secondary psychiatric care. The amount of mental health nurses at the health centres correlated inversely with the number of secondary psychiatric outpatient visits, whereas its relation to inpatient days and admission was positive. The costs of secondary psychiatric care correlated with level of psychiatric morbidity and socioeconomic indicators of need. The results suggest that when aiming at equal access of care and cost-efficiency, the primary and secondary care should be organized and planned with integrative collaboration.
Topic(s):
Financing & Sustainability
See topic collection
Reference Links:
View the DOI record for Does primary care mental health resourcing affect the use and costs of secondary psychiatric services?
View DOI Record
View the PubMed citation for Does primary care mental health resourcing affect the use and costs of secondary psychiatric services?3234
Does race make a difference among primary care patients with alcohol problems who agree to enroll in a study of brief interventions?
Type: Journal Article
Year: 2000
Publication Place: United States
Abstract: This study describes the severity, alcohol consumption, consequences, readiness to change, and coping behaviors of African-American and white primary care patients enrolled in a trial of brief interventions for problem drinking. In multivariate analysis, unemployment but not race was associated with clinical indicators of alcohol problems. African-Americans reported no difference in alcohol consumption and similar quality of life scores. African-American race and unemployment were both associated with increased identification and resolution of alcohol problems. There was no difference in readiness to change, but African-Americans reported more problems related to alcohol and greater use of coping behaviors to avoid drinking. African-Americans may be better equipped to manage drinking problems when they do occur due to increased familiarity with coping mechanisms.
Topic(s):
Healthcare Disparities
See topic collection
, Opioids & Substance Use
See topic collection
3236
Does screening for depression in primary care improve outcome?
Type: Journal Article
Year: 2012
Publication Place: United States
Abstract: 2012 marks one decade since the US Preventive Services Task Force recommended screening for depression. Advances since then include expanded understanding of the mechanisms underlying and influences of psychiatric disease on the development, course and outcomes of medical conditions. They also include collaborative care strategies to improve outcomes. However, the impact of such single disease approaches has been disappointing. Strategies that integrate management of multiple morbidities into primary care practice have greatly improved outcomes. Depression has been the only psychiatric condition incorporated into these strategies. Their expansion to integrate recognition and care of bipolar disease, anxiety disorders including PTSD, and substance abuse could further improve outcomes with modest marginal cost. Development of a screening and treatment monitoring instrument for multiple common psychiatric conditions is a prerequisite. One recently developed instrument, the M3, has the performance characteristics desirable, and provides opportunity to incorporate multiple common psychiatric conditions into multimorbidity integrated management.
Topic(s):
Measures
See topic collection
, Healthcare Disparities
See topic collection
Reference Links:
View the DOI record for Does screening for depression in primary care improve outcome?
View DOI Record
View the PubMed citation for Does screening for depression in primary care improve outcome?3239
Does shared care help in the treatment of depression?
Type: Journal Article
Year: 2010
Publication Place: Croatia
Abstract: INTRODUCTION: shared or Collaborative Care in the treatment of Depression is an evidence based intervention which has been shown to be more effective than ordinary general Practitioner care in the treatment of Depression, however, it is not yet Government policy in the United Kingdom. We aimed to bring together in one place all the studies which have been carried out, up till mid 2009, in order to demonstrate the evidence that shared collaborative care has important advantages in terms both of depression outcomes and cost benefits, in order to argue for the adoption of this approach in the United Kingdom and n Europe. METHODS: we carried out a literature search using PUBMED in order to identify and describe all trials, systematic reviews and Metanalyses which have been carried out on shared care until mid 2009. We also described a shared care service for depression which some of us had been involved in developing and working in in Luton in the late 1990's. We have excluded papers which describe trials which have not yet been carried out, and instead focussed on the trials which have reported. RESULTS: it has been demonstrated in numerous recent studies that shared care in the treatment of depression, which includes the training of General Practitoners in the treatment of depression, and the provision in Primary Care of a Nurse specialist or another professional who will impart psycho-education, ensure concordance with medication, and may provide psychotherapy, leads to both improved treatment outcomes and increased doctor and patient satisfaction, as well providing some cost-benefits, despite somewhat increased immediate costs. This is the case in both adult and adolescent patients, while in the case of diabetic patients depression is improved, despite the lack of improvement in glycaemic control. The shared care intervention continues to be useful in the case of patients with resistant depressive symptoms, though a longer input will be necessary in such cases. Patients with subthreshold depression will not benefit as much, and patients expressed more satisfaction when psychological interventions were offered. It is also the case that collaborative or shared care is effective in treating depression in the elderly. This is shown by studies which include older patients who also suffer from multiple health conditions, arthritis, diabetes, anxiety and PTSD, the poorer, those with suicidal ideation, and also in Ethnic Minorities. DISCUSSION: The results described above are mostly based on studies carried out in the USA, but similar studies have been reported from the United Kingdom, and are consistent with the experience of the service in Luton which we describe. From these results it would seem important that shared, collaborative care, with primary and secondary care doctors (General Practitioners and Psychiatrists) working as part of a single team, with the help of mental health practitioners attached to primary care, but with easy access to secondary care is a productive way of optimising the treatment of depression. In the UK, however, it has not yet been possible to develop such a service for the whole population. This is becausein the UK, General Practice is managed by Primary Care Trusts, while Secondary Care, including Psychiatry, is managed by Mental Health Trusts. This has led the National Institute of Health and Clinical Excellence, and indeed local commissioners of care to focus on a Stepped Model for the treatment of depression, with one key issue being access (or referral) to secondary care, and discharge back to primary care, with a group of Mental Health workers focussing on the facilitation (or gate-keeping) of these processes, rather than focussing on actually optimising outcomes of care. CONCLUSION: the evidence argues for the development of collaborative care between primary and secondary care for the treatment of Depression. This will require common medication guidelines across both Primary and Secondary Care, easy access so that General Practitioners can receive advice from Psychiatrists about patients, and the use of Mental Health Professionals to provide patients with psycho-education, support of concordance with treatment, and psychotherapy. It may be that, in order for this to be achieved, services may need to be re-structured, to allow easy communication between professionals.
Topic(s):
Financing & Sustainability
See topic collection
, Healthcare Policy
See topic collection