Literature Collection

9961

The Medical Home Transformation in the Veterans Health Administration: An Evaluation of Early Changes in Primary Care Delivery

Type: Journal Article

Authors: Rachel M. Werner, Anne Canamucio, Judy A. Shea, Gala True

Year: 2014

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9962

The medical home, preventive care screenings, and counseling for children: Evidence from the Medical Expenditure Panel Survey

Type: Journal Article

Authors: M. A. Romaire, J. F. Bell

Year: 2010

Publication Place: United States

Abstract: OBJECTIVE: Little is known about the role of the medical home in promoting essential preventive health care services in the general pediatric population. This study examined associations between having a medical home and receipt of health screenings and anticipatory guidance. METHODS: We conducted a cross-sectional analysis of the 2004-2006 Medical Expenditure Panel Survey (MEPS). Our sample included 21 055 children aged 0 to 17 years who visited a health care provider in the year prior to the survey. A binary indicator of the medical home was developed from 22 questions in MEPS, reflecting 4 of the 7 American Academy of Pediatrics' recommended components of the medical home: accessible, family-centered, comprehensive, and compassionate care. Multivariable logistic regression was used to examine the association between the medical home and receipt of specific health screenings and anticipatory guidance, controlling for confounding variables. RESULTS: Approximately 49% of our study sample has a medical home. The medical home, defined when the usual source of care is a person or facility, is significantly associated with 3 health screenings (ie, weight, height, and blood pressure) and several anticipatory guidance topics (ie, advice about dental checkups, diet, exercise, car and bike safety), with odds ratios ranging from 1.26 to 1.54. CONCLUSIONS: The medical home is associated with increased odds of children receiving some health screenings and anticipatory guidance. The medical home may provide an opportunity to improve the delivery of these services for children.

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9963

The medical home: A model for 21st century health care

Type: Web Resource

Authors: M . Y. Mann

Year: 2009

Publication Place: Arlington, VA

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This grey literature reference is included in the Academy's Literature Collection in keeping with our mission to gather all sources of information on integration. Grey literature is comprised of materials that are not made available through traditional publishing avenues. Often, the information from unpublished resources can be limited and the risk of bias cannot be determined.

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9964

The medical home: Growing evidence to support a new approach to primary care

Type: Journal Article

Authors: T. C. Rosenthal

Year: 2008

Publication Place: United States

Abstract: INTRODUCTION: A medical home is a patient-centered, multifaceted source of personal primary health care. It is based on a relationship between the patient and physician, formed to improve the patient's health across a continuum of referrals and services. Primary care organizations, including the American Board of Family Medicine, have promoted the concept as an answer to government agencies seeking political solutions that make quality health care affordable and accessible to all Americans. METHODS: Standard literature databases, including PubMed, and Internet sites of numerous professional associations, government agencies, business groups, and private health organizations identified over 200 references, reports, and books evaluating the medical home and patient-centered primary care. FINDINGS: Evaluations of several patient-centered medical home models corroborate earlier findings of improved outcomes and satisfaction. The peer-reviewed literature documents improved quality, reduced errors, and increased satisfaction when patients identify with a primary care medical home. Patient autonomy and choice also contributes to satisfaction. Although industry has funded case management models demonstrating value superior to traditional fee-for-service reimbursement adoption of the medical home as a basis for medical care in the United States, delivery will require effort on the part of providers and incentives to support activities outside of the traditional face-to-face office visit. CONCLUSIONS: Evidence from multiple settings and several countries supports the ability of medical homes to advance societal health. A combination of fee-for-service, case management fees, and quality outcome incentives effectively drive higher standards in patient experience and outcomes. Community/provider boards may be required to safeguard the public interest.

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9965

The medical home: Health care access and impact for children and youth in the United States

Type: Journal Article

Authors: B. B. Strickland, J. R. Jones, R. M. Ghandour, M. D. Kogan, P. W. Newacheck

Year: 2011

Publication Place: United States

Abstract: OBJECTIVE: The medical home concept encompasses the elements of pediatric care considered essential for all children. We describe here the characteristics of children with medical homes and the relationship between presence of a medical home and selected health care outcomes by using new data from the 2007 National Survey of Children's Health (NSCH). METHODS: We used a medical home measure comprising 5 components: having a usual source of care; having a personal physician or nurse; receiving all needed referrals for specialty care; receiving help as needed in coordinating health and health-related care; and receiving family-centered care. A total of 83 448 children aged 1 to 17 years had valid data for all applicable medical home components. The NSCH is a random-digit-dial population-based telephone survey. RESULTS: In 2007, 56.9% of US children aged 1 to 17 years received care in medical homes. Younger children were more likely to have a medical home than their older counterparts. Substantial racial/ethnic, socioeconomic, and health-related disparities were present. Children who received care in medical homes were less likely to have unmet medical and dental needs and were more likely to have annual preventive medical visits. CONCLUSIONS: Approximately half of the children in the United States have access to all components of a pediatric medical home. Because the medical home is increasingly promoted as the standard for provision of high-quality comprehensive health care, these findings reinforce the need to continue and expand federal, state, and community efforts to ensure that all children have access to this model of care.

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9966

The medical home: Locus of physician formation

Type: Journal Article

Authors: T. P. Daaleman

Year: 2008

Publication Place: United States

Abstract: Family medicine is currently undergoing a transformation and, amid such change, the medical home has emerged as the new polestar. This article examines the medical home through the lens of philosopher Alasdair MacIntyre and offers a perspective, informed by Hubert Dreyfus and Peter Senge, about medical homes as practical sites of formation for family physicians. The intellectual past of family medicine points to contextually sensitive patient care as a practice that is particular to the discipline, with the virtue of "placing patients within contexts over time" as a commonly held virtue. Dreyfus provides a model of knowledge and skill acquisition that is relevant to the training of family physicians in practical wisdom. In this model, there is a continuum from novice to more advanced stages of professional formation that is aided by rules that not only must be learned, but must be applied in greater contextually informed situations. Senge's emphasis on learning organizations-organizations where people are continually learning how to learn together-presents a framework for evaluating the extent to which future medical homes facilitate or retard the formation of family physicians.

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9967

The Medical-Psychiatric Coordinating Physician-Led Model: Team-Based Treatment for Complex Patients

Type: Journal Article

Authors: S. A. Frankel, J. A. Bourgeois, G. Xiong, R. McCarron, J. Han, P. Erdberg

Year: 2014

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9968

The Mental Health and Substance Use Workforce for Older Adults: In Whose Hands?

Type: Government Report

Authors: Jill Eden, Katie Maslow, Mai Le, Dan Blazer

Year: 2012

Abstract: At least 5.6 million to 8 million--nearly one in five--older adults in America have one or more mental health and substance use conditions, which present unique challenges for their care. With the number of adults age 65 and older projected to soar from 40.3 million in 2010 to 72.1 million by 2030, the aging of America holds profound consequences for the nation.For decades, policymakers have been warned that the nation's health care workforce is ill-equipped to care for a rapidly growing and increasingly diverse population. In the specific disciplines of mental health and substance use, there have been similar warnings about serious workforce shortages, insufficient workforce diversity, and lack of basic competence and core knowledge in key areas. Following its 2008 report highlighting the urgency of expanding and strengthening the geriatric health care workforce, the IOM was asked by the Department of Health and Human Services to undertake a complementary study on the geriatric mental health and substance use workforce. An expert committee assessed the needs of this population and the workforce that serves it. The breadth and magnitude of inadequate workforce training and personnel shortages have grown to such proportions, says the committee, that no single approach, nor a few isolated changes in disparate federal agencies or programs, can adequately address the issue. Overcoming these challenges will require focused and coordinated action by all.

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This grey literature reference is included in the Academy's Literature Collection in keeping with our mission to gather all sources of information on integration. Grey literature is comprised of materials that are not made available through traditional publishing avenues. Often, the information from unpublished resources can be limited and the risk of bias cannot be determined.

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9969

The mental health of doctor-shoppers: experience from a patient-led fee-for-service primary care setting

Type: Journal Article

Authors: J. Norton, G. de Roquefeuil, M. David, J. P. Boulenger, K. Ritchie, A. Mann

Year: 2011

Publication Place: Netherlands

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9970

The mental health professions: Workforce supply and demand, issues, and challenges

Type: Journal Article

Authors: W. N. Robiner

Year: 2006

Publication Place: United States

Abstract: The U.S. mental health (MH) workforce is comprised of core disciplines: psychology, psychiatry, social work, psychiatric nursing, and marriage and family therapy. A broader group of practitioners also deserves recognition. Diverse professions provide significant services in a variety of settings, extending the de facto mental health workforce. A tally of key disciplines estimates there are 537,857 MH professionals, or 182 per 100,000 U.S. population. This article provides an overview of the need and demand for mental health services and summarizes the MH professions (e.g., training, educational credentials, workforce estimates). It also discusses a range of challenges confronting MH professionals and the need for greater understanding of the workforce and integration of services. Methodological factors that confound estimates of the magnitude of the MH workforce are reviewed.

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9971

The Mental Health workforce in Texas: A snapshot of the issues

Type: Report

Authors: Hogg Foundation for Mental Health

Year: 2007

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Texas is in urgent need of more well-trained and supported mental health professionals. The majority of the state's counties are characterized by a shortage of mental health professionals, with declines in supply in recent years most notably affecting rural areas. Both leaders of Texas state agencies and community healthcare organizations report extensive problems in recruitment and retention and insufficient training capacity. Existing supply gaps in mental health providers are likely to increase as an aging workforce begins to retire and job availability for mental health professions increases. Despite the number of Texas universities offering professional education in mental health fields, insufficient attempts are being made to research and promote organized and widespread recruitment and retention activities. People of color are underrepresented in mental health professions, and Texas appears to be lacking in effective racial and culturally diverse recruitment in the mental health professions. This snapshot of the current state of the Texas mental health workforce provides preliminary information to highlight issues that key stakeholders--professionals, employers, higher education, consumers of services, and licensing boards, among others--must address to assure the availability of a qualified mental health workforce.

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This grey literature reference is included in the Academy's Literature Collection in keeping with our mission to gather all sources of information on integration. Grey literature is comprised of materials that are not made available through traditional publishing avenues. Often, the information from unpublished resources can be limited and the risk of bias cannot be determined.

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9972

The mental health/primary care interface in the United States: history, structure, and context

Type: Journal Article

Authors: B. G. Druss

Year: 2002

Publication Place: United States

Abstract: This paper, the first in a series commissioned by NIMH for the "Challenges for the 21st Century: Mental Health Services Research Conference," seeks to provide a broad perspective on the primary care/mental health interface in the United States. The manuscript examines both the care of mental disorders in medical settings, and also the medical care of the seriously medically ill. The first section provides a historical overview of the cycling patterns of growth and retrenchment of primary care medicine during the 20th century, and the how those changes have paralleled the care of mental disorders and the mentally ill. The second section examines the four core features of primary care -first contact, longitudinality, comprehensiveness and coordination -and their implications for these issues. An historical and system-level perspective can provide a crucial step towards improving care on the mental health/primary care interface.

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9973

The Michigan Child Care Collaborative Program: Building a Telepsychiatry Consultation Service

Type: Journal Article

Authors: S. Marcus, N. Malas, R. Dopp, J. Quigley, A. C. Kramer, E. Tengelitsch, P. D. Patel

Year: 2019

Publication Place: United States

Abstract: This column describes the establishment of the Michigan Child Care Collaborative (MC3), a statewide telepsychiatry consultation program that provides support to primary care providers (PCPs) in meeting the mental health needs of youths and perinatal women. The MC3 program provides cost-effective, timely, remote consultation to primary care providers in an effort to address the lack of access and scarcity of resources in child, adolescent, and perinatal psychiatry. Data from 10,445 service requests are summarized. Common diagnoses included attention-deficit hyperactivity disorder, mood disorders, anxiety disorders, and autistic spectrum disorders, with many cases (58%) deemed moderate to severe. Co-occurring psychological trauma was suspected in 9% of service requests. Partnerships, stakeholder roles, PCP engagement, and workflow integration are highlighted as keys to the program's success.

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9974

The mixed attitudes of nurse's to caring for people with mental illness in a rural general hospital

Type: Journal Article

Authors: F. Reed, L. Fitzgerald

Year: 2005

Publication Place: Australia

Abstract: Mainstreaming of mental health care and the prevalence of mental illness have increased the requirement for care by nurses in the general hospital setting. In rural Australia, mental health services are limited and nurses have less access to support and education. Little is known about how these factors influence attitudes and the care of people with mental illness in rural hospitals. A qualitative descriptive study was used to investigate nurses' attitudes to caring for people with mental illness, the issues that impact on their ability to provide care, and the effect of education, experience, and support. In 2003, 10 nurses from two wards in a rural hospital were interviewed. Participants from one ward had education and support from mental health nurses. Attitudes were found to be inextricably linked to issues that influence nurses' ability to provide care. Dislike was apparent from nurses who suggested it was not their role. Others identified fear, causing avoidance. Conversely, those receiving support and education described increased comfort, with some nurses expressing enthusiasm for mental health care, seeing it as integral to nursing. The priority of physical care, time constraints, environmental unsuitability, rurality, and the lack of skill, knowledge, and mental health services reduced safety and effective care. A limited ability to help was reported, despite support for Mental Health Strategy goals. Positive experience promoted through education and support was required for nurses to improve care and attitudes. Notably, collaboration with mental health nurses was identified as helping nurses overcome fear and increase competence in caring for people with mental illness.

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9975

The Mixed Opioid Receptor Antagonist Naltrexone Mitigates Stimulant-Induced Euphoria: A Double-Blind, Placebo-Controlled Trial of Naltrexone

Type: Journal Article

Authors: T. J. Spencer, P. Bhide, J. Zhu, S. V. Faraone, M. Fitzgerald, A. M. Yule, M. Uchida, A. E. Spencer, A. M. Hall, A. J. Koster, L. Feinberg, S. Kassabian, B. Storch, J. Biederman

Year: 2018

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9976

The Mobile Health Experience-A Blueprint for Expanding Access to Substance Abuse Treatment

Type: Journal Article

Authors: Carol B. Butler, Suzan Swanton

Year: 2005

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9977

The mobile revolution and the DBT Coach

Type: Journal Article

Authors: Linda A. Dimeff, Shireen L. Rizvi, Ignacio S. Contreras, Julie M. Skutch, David Carroll

Year: 2011

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9978

The Montana model: Integrated primary care and behavioral health in a family practice residency program

Type: Journal Article

Authors: C. Oakley, D. Moore, D. Burford, R. Fahrenwald, K. Woodward

Year: 2005

Publication Place: United States

Abstract: To address the local health care needs of both patients and primary care providers in Montana, an integrated primary care and behavioral health family practice clinic was developed. In this paper we describe our experience with integrating mental health and substance abuse services into a primary care setting (a community health center) while simultaneously teaching family practice physicians to take the lead in providing these services. The Deering Community Health Center in Billings, Montana, is a Federally Qualified Health Center serving a largely low-income patient population. The medical care at the clinic is provided primarily by the faculty and residents of the Montana Family Medicine Residency. The teaching model was founded on the belief that improved care will result when physicians have increased comfort with, and are able to enjoy the challenges of, patients with mental illnesses. The enhanced longitudinal curriculum incorporates mental health across the 3 years of the family practice residency. Unique characteristics of this model include staffing and the concurrent delivery of a high volume mental health service while teaching family practice resident physicians and the faculty to integrate this competency into their primary care practices.

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9979

The Mood Disorder Questionnaire

Type: Report

Authors: R. M. A. Hirschfield, J. R. Calabrese, L. Flynn, P.E. Keck Jr, L. Lewis, R. M. Post, G. S. Sachs, R. L. Spitzer, J. Williams, J. M. Zajecka

Year: 2000

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This grey literature reference is included in the Academy's Literature Collection in keeping with our mission to gather all sources of information on integration. Grey literature is comprised of materials that are not made available through traditional publishing avenues. Often, the information from unpublished resources can be limited and the risk of bias cannot be determined.

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9980

The Multidimensional Behavioral Health Screen 1.0: A Translational Tool for Primary Medical Care

Type: Journal Article

Authors: David M. McCord

Year: 2020

Publication Place: Philadelphia

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