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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).
11196 Results
11041
What constitutes "behavioral health"? Perceptions of substance-related problems and their treatment in primary care
Type: Journal Article
Year: 2020
Abstract:
BACKGROUND: Integrating behavioral health in primary care is a widespread endeavor. Yet rampant variation exists in models and approaches. One significant question is whether frontline providers perceive that behavioral health includes substance use. The current study examined front line providers': 1. definition of behavioral health, and 2. levels of comfort treating patients who use alcohol and other drugs. Frontline providers at two primary care clinics were surveyed using a 28-item instrument designed to assess their comfort and knowledge of behavioral health, including substance use. Two questions from the Integrated Behavioral Health Staff Perceptions Survey pertaining to confidence in clinics' ability to care for patients' behavioral health needs and comfort dealing with patients with behavioral health needs were used for the purposes of this report. Participants also self-reported their clinic role. Responses to these two items were assessed and then compared across roles. Chi square estimates and analysis of variance tests were used to examine relationships between clinic roles and comfort of substance use care delivery. RESULTS: Physicians, nurses/nurse practitioners, medical assistants, and other staff (N = 59) participated. Forty-nine participants included substance use in their definition of behavioral health. Participants reported the least comfort caring for patients who use substances (M = 3.5, SD = 1.0) compared to those with mental health concerns (M = 4.1, SD = 0.7), chronic medical conditions (M = 4.2, SD = 0.7), and general health concerns (M = 4.2, SD = 0.7) (p < 0.001). Physicians (M = 3.0, SD = 0.7) reported significantly lower levels of comfort than medical assistants (M = 4.2, SD = 0.9) (p < 0.001) caring for patients who use substances. CONCLUSIONS: In a small sample of key stakeholders from two primary care clinics who participated in this survey, most considered substance use part of the broad umbrella of behavioral health. Compared to other conditions, primary care providers reported being less comfortable addressing patients' substance use. Level of comfort varied by role, where physicians were least comfortable, and medical assistants most comfortable.
Topic(s):
Education & Workforce
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, Opioids & Substance Use
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Reference Links: 
View the DOI record for What constitutes "behavioral health"? Perceptions of substance-related problems and their treatment in primary care
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View the PubMed citation for What constitutes "behavioral health"? Perceptions of substance-related problems and their treatment in primary care11043
What do general practice patients want when they present medically unexplained symptoms, and why do their doctors feel pressurized?
Type: Journal Article
Year: 2005
Publication Place: England
Abstract: OBJECTIVE: We tested predictions that patients with medically unexplained symptoms (MUS) want more emotional support and explanation from their general practitioners (GPs) than do other patients, and that doctors find them more controlling because of this. DESIGN: Thirty-five doctors participated in a cross-sectional comparison of case-matched groups. Three hundred fifty-seven patients attending consecutively with MUS were matched for doctor and time of attendance with 357 attending with explained symptoms. Patients self-reported the extent to which they wanted somatic intervention, emotional support, explanation and reassurance. Doctors rated their perception of patients' influence on the consultation. Predictions were tested by multilevel analyses. RESULTS: Patients with MUS sought more emotional support than did others, but no more explanation and reassurance or somatic intervention. A minority of doctors experienced them as exerting more influence than others. The experience of patient influence was related to the patients' desire for support. CONCLUSIONS: Future research should examine why GPs provide disproportionate levels of somatic intervention to patients who seek, instead, greater levels of emotional support.
Topic(s):
Medically Unexplained Symptoms
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11045
What do primary care doctors get out of a year-long postgraduate course in community psychological medicine?
Type: Journal Article
Year: 2011
Publication Place: United States
Abstract: OBJECTIVE: There are increasing expectations on primary care doctors to care for patients with common mental health problems. This study examines the outcomes of a postgraduate training course in psychological medicine for primary care doctors. METHODS: A questionnaire developed by the research team was sent to the Course graduates (year 2003-2007). A retrospective design was adopted to compare their clinical practice characteristics before and after the Course. Differences in the ratings by the respondents before and after the Course were analyzed using the nonparametric Wilcoxon signed rank test. RESULTS: Sixty-nine graduates replied with a response rate of 58.5% (69/118). Most respondents were confident of diagnosing (96.9%) and managing (97.0%) common mental health problems after the Course, compared to 50.0% and 50.7%, respectively, before the Course. Most graduates had modified their approach, increased their attention and empathy to patients with mental health problems. The percentage of respondents having enough time to treat these patients had increased from 55.8% to 72.1%. The median number of patients with mental health problems seen per week was in the range of 3-6 before, and had increased to the range of 7-10 after the Course. The proportion of respondents being confident of making appropriate referrals had increased from 72.8% to 97.0%, while the number of referrals to psychiatrists had dropped significantly. CONCLUSIONS: The Course is effective in improving graduates' confidence, attitude, and skills in treating patients with common mental health problems. There are significant increases in the number of mental health patients handled, increased confidence in making referrals to psychiatrists, and decreased percentage of patients being referred.
Topic(s):
Education & Workforce
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Reference Links: View the PubMed citation for What do primary care doctors get out of a year-long postgraduate course in community psychological medicine?
11046
What does it mean to "employ" the RE-AIM model?
Type: Journal Article
Year: 2013
Publication Place: United States
Abstract: Many grant proposals identify the use of a given evaluation model or framework but offer little about how such models are implemented. The authors discuss what it means to employ a specific model, RE-AIM, and key dimensions from this model for program planning, implementation, evaluation, and reporting. The authors report both conceptual and content specifications for the use of the RE-AIM model and a content review of 42 recent dissemination and implementation grant applications to National Institutes of Health that proposed the use of this model. Outcomes include the extent to which proposals addressed the overall RE-AIM model and specific items within the five dimensions in their methods or evaluation plans. The majority of grants used only some elements of the model (less than 10% contained thorough measures across all RE-AIM dimensions). Few met criteria for "fully developed use" of RE-AIM and the percentage of key issues addressed varied from, on average, 45% to 78% across the RE-AIM dimensions. The results and discussion of key criteria should help investigators in their use of RE-AIM and illuminate the broader issue of comprehensive use of evaluation models.
Topic(s):
General Literature
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11048
What Does It Take for Primary Care Practices to Truly Deliver Behavioral Health Care?
Type: Journal Article
Year: 2014
Topic(s):
General Literature
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Reference Links:
View the DOI record for What Does It Take for Primary Care Practices to Truly Deliver Behavioral Health Care?
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View the PubMed citation for What Does It Take for Primary Care Practices to Truly Deliver Behavioral Health Care?11052
What fosters or prevents interprofessional teamworking in primary and community care? A literature review
Type: Journal Article
Year: 2008
Publication Place: England
Abstract: BACKGROUND: The increase in prevalence of long-term conditions in Western societies, with the subsequent need for non-acute quality patient healthcare, has brought the issue of collaboration between health professionals to the fore. Within primary care, it has been suggested that multidisciplinary teamworking is essential to develop an integrated approach to promoting and maintaining the health of the population whilst improving service effectiveness. Although it is becoming widely accepted that no single discipline can provide complete care for patients with a long-term condition, in practice, interprofessional working is not always achieved. OBJECTIVES: This review aimed to explore the factors that inhibit or facilitate interprofessional teamworking in primary and community care settings, in order to inform development of multidisciplinary working at the turn of the century. DESIGN: A comprehensive search of the literature was undertaken using a variety of approaches to identify appropriate literature for inclusion in the study. The selected articles used both qualitative and quantitative research methods. FINDINGS: Following a thematic analysis of the literature, two main themes emerged that had an impact on interprofessional teamworking: team structure and team processes. Within these two themes, six categories were identified: team premises; team size and composition; organisational support; team meetings; clear goals and objectives; and audit. The complex nature of interprofessional teamworking in primary care meant that despite teamwork being an efficient and productive way of achieving goals and results, several barriers exist that hinder its potential from becoming fully exploited; implications and recommendations for practice are discussed. CONCLUSIONS: These findings can inform development of current best practice, although further research needs to be conducted into multidisciplinary teamworking at both the team and organisation level, to ensure that enhancement and maintenance of teamwork leads to an improved quality of healthcare provision.
Topic(s):
Education & Workforce
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Reference Links:
View the DOI record for What fosters or prevents interprofessional teamworking in primary and community care? A literature review
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View the PubMed citation for What fosters or prevents interprofessional teamworking in primary and community care? A literature review11053
What general emergency nurses want to know about mental health patients presenting to their emergency department
Type: Journal Article
Year: 2007
Publication Place: Scotland
Abstract: This paper presents the findings of a qualitative project conducted to investigate the education and training requirements that non-mental health trained emergency nurses need to enable them to effectively care for psychiatric patients presenting to a West Australian emergency department. Non-mental health trained nurses are ill-equipped in their psychiatric knowledge, assessment and communication skills to provide best possible care to the one in ten patients presenting to the emergency department with a complex mental health issue. The area of assessment and management of mental health patients in the emergency department is a complex one and staff are required to assess, triage and manage these patients appropriately. Furthermore, with aggression and violence increasing, emergency department nurses are concerned about their safety in the workplace. Focus groups with emergency nurses and semi-structured interviews with subject matter experts were conducted at one West Australian teaching hospital. The findings of the project demonstrated that these nurses considered that customer focus, workplace aggression and violence, psychiatric theory, mental health assessment and chemical dependence as key learning areas. These findings will form a platform for further education and training for ED staff.
Topic(s):
Education & Workforce
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Reference Links:
View the DOI record for What general emergency nurses want to know about mental health patients presenting to their emergency department
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View the PubMed citation for What general emergency nurses want to know about mental health patients presenting to their emergency department11056
What is integrated care?
Type: Journal Article
Year: 2014
Publication Place: England
Abstract: Abstract Increasing awareness of mental illness's impact on medical and psychiatric health has accelerated global efforts to integrate medical and behavioural health services. As the field of integration has advanced, numerous integrated programmes have been implemented. In examining the impact of these programmes, it is important to maintain a standardized vocabulary to describe the various components of their integration. Additionally important is examination of how these programmes impact elements of patient care and the healthcare system. Specifically, what value do they bring? This article will discuss the importance of carefully assessing the value integrated services bring to patients, and questioning whether they do so in ways in which today's segregated world of medical and behavioural health cannot. This article will also explore the various settings in which medical and behavioural integration can bring added value.
Topic(s):
Key & Foundational
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Reference Links:
View the DOI record for What is integrated care?
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View the PubMed citation for What is integrated care?Export Citation: Download the RIS reference file for What is integrated care?
11057
What is known about community pharmacy supply of naloxone? A scoping review
Type: Journal Article
Year: 2016
Publication Place: Netherlands
Topic(s):
Opioids & Substance Use
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, Education & Workforce
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, Financing & Sustainability
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Reference Links:
View the DOI record for What is known about community pharmacy supply of naloxone? A scoping review
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View the PubMed citation for What is known about community pharmacy supply of naloxone? A scoping review11060
What is the evidence for the efficacy of treatments for somatoform disorders? A critical review of previous intervention studies
Type: Journal Article
Year: 2007
Publication Place: United States
Abstract: OBJECTIVE: To review published literature for the highest level of evidence on the efficacy of treatment for patients with medically unexplained symptoms. METHODS: A comprehensive literature search was carried out in Cochrane library, Medline (1971-2007), PsychINFO (1974-2006), and EMBASE (1980-2007) to identify pharmacological, nonpharmacological, psychological, and other interventions, using the search terms "medically unexplained symptoms," "somatisation," "somatization," "somatoform disorders," "psychological therapies," "cognitive behavior therapy," "pharmacological therapies," "management," "therapy," "drug therapy," and "anti-depressants" with Boolean operators AND and OR on the entire text. Searches were confined to literature in English. RESULTS: Studies were carried out in primary, secondary, and tertiary care settings. The therapists ranged from medical specialists, psychiatrists, and psychologists to primary care physicians. Three types of interventions (antidepressant medication, cognitive behavioral therapy (CBT), and other nonspecific interventions) were supported by evidence on the efficacy of treatment for patients with medically unexplained symptoms. There is more level I evidence for CBT compared with the amount for other approaches. There was only one study reported from the developing world. CONCLUSIONS: CBT is efficacious for either symptom syndromes or for the broader category of medically unexplained symptoms, reducing physical symptoms, psychological distress, and disability. A relatively small number of studies were carried out in primary care, but the trend has been changing over the last decade. No studies have compared pharmacological and psychological treatments. Most trials assessed only short-term outcomes. Use of divergent selection procedures, interventions, outcome measures, and instruments, and other methodological differences observed in these studies hamper the ability to compare treatment effects across studies.
Topic(s):
Medically Unexplained Symptoms
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