Literature Collection

Untreated co-occurring mental health disorders (MHD) and substance use disorders (SUD) are associated with negative treatment outcomes. This study explored the experiences and perspectives of patients with opioid use disorder (OUD) who were using methamphetamine while undergoing methadone maintenance treatment (MMT) regarding barriers and facilitators to accessing MHD services. We conducted 30 in-depth interviews with MMT participants with varying levels of MHD severity, assessed using the 21-item Depression, Anxiety, Stress Scale (DASS-21). Barriers to seeking MHD services included lack of awareness, fear of additional stigma and extra burden to families, unaddressed poly-substance use, and lack of specialized professionals. Benefits of integrating MHD services into MMT clinics included improved diagnosis, streamlined referrals, and reduced logistical challenges. Key facilitators identified included supportive family members, healthcare professionals, and digital platforms. Integrating MHD care into MMT, emphasizing family involvement, staff training, and digital platforms, holds promise to improve MHD diagnosis, referral, and treatment.

BACKGROUND: Mental health specialists and care managers facilitate comprehensive care provision within medical homes. Despite implementation challenges, mental health integration is thought to improve patient-centered primary care. OBJECTIVES: To examine the relationship between primary care patient experience and mental health integration. RESEARCH DESIGN: Cross-sectional surveys from 168 primary care clinicians (PCPs) (n = 226) matched with assigned patients' surveys (n = 1734) in one Veterans Health Administration (VA) region, fiscal years 2012-2013. Multilevel regression models examined patient experience and mental health integration, adjusting for patient and PCP characteristics. MEASURES: Patient experience outcomes were (1) experience with PCP and (2) receipt of comprehensive care, such as talked about "stress". Independent variables represented mental health integration- (1) PCP-rated communication with mental health and (2) proportion of clinic patients who saw integrated specialists. RESULTS: 50% and 43% of patients rated their PCPs 10/10 and reported receiving comprehensive care, respectively. Neither patient experience or receipt of comprehensive care was significantly associated with PCP's ratings of communication with mental health, nor with proportion of clinic patients who saw integrated specialists. Among a subsample of patients who rated their mental health as poor/fair, however, we detected an association between proportion of clinic patients who saw integrated specialists and patient experience (odds ratio = 1.05, 95% confidence interval = 1.01-1.09, p = .01). CONCLUSIONS: No association was observed between mental health integration and primary care patients' reported care experiences, but a significant association existed among patients who reported poor/fair mental health. More research is needed to understand patient experiences with regard to care model implementation.

Despite advances in treatment, the mental health challenges of individuals living with Sickle Cell Disease (SCD) remain critically overlooked. Depression, anxiety, and post-traumatic stress disorder disproportionately affect this population, yet mental health support is often inadequate or absent. This paper presents patient-driven insights into the psychological toll of SCD, emphasizing the urgent need for integrated care approaches that address both physical and mental health. By exploring barriers to mental health access, the impact of medical trauma, and strategies for resilience, we aim to shift the conversation toward a more holistic, patient-centered model of SCD care.