Integration Of Mental Health Substance Abuse And Primary Care
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Integration Of Mental Health Substance Abuse And Primary Care
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Author : U. S. Department of Health and Human Services
language : en
Publisher: CreateSpace
Release Date : 2013-08-21
Integration Of Mental Health Substance Abuse And Primary Care written by U. S. Department of Health and Human Services and has been published by CreateSpace this book supported file pdf, txt, epub, kindle and other format this book has been release on 2013-08-21 with Medical categories.
There is a need to improve care at the interface of general medicine and mental health. Provision of care at this interface is the aim of integrated care. Integrated care occurs when mental health specialty and general medical care providers work together to address both the physical and mental health needs of their patients. This comprehensive systematic review addresses the evidence for integration of mental health services into primary care settings and primary services into specialty outpatient settings. The research questions were: 1) What models of integration have been used? a) What theoretical models support these programs? b) What is the evidence that integrated care leads to better outcomes? 2) To what extent does the impact of integrated care programs on outcomes vary for different populations (e.g., specific mental illness conditions, chronically ill, racial/ethnic groups, elderly/youth)? 3) What are the identified barriers to successful integration? a) How were barriers overcome? b) What are the barriers to sustainability? 4) To what extent did successful integration programs make use of health information technology (IT)? 5) What financial and/or reimbursement structure was employed in successful integration programs? Is there evidence to suggest that any specific financial/reimbursement strategy is superior to another? 6) What are the key elements of programs that have been successfully implemented and sustained in large health systems? To what extent do they follow, or how do they differ from, models that have been studied in published research studies? The scope of the review included alcohol addiction but not other forms of substance abuse. Inpatient settings are also excluded. The review focuses on four areas: (1) specifying what integration is (and is not); (2) detailing the process through which integrated care may affect clinical outcomes; (3) expanding beyond the scope of prior reviews to include multiple illnesses and patient populations; and (4) specifying the conditions under which various models of integrated care are likely (or unlikely) to work in 'real-world' settings. This review also conducted case studies in order to better understand the implementation of integrated care models.
Integration Of Mental Health Substance Abuse And Primary Care
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Author : Mary Butler (Ph.D.)
language : en
Publisher:
Release Date : 2008
Integration Of Mental Health Substance Abuse And Primary Care written by Mary Butler (Ph.D.) and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 2008 with Evidence-based medicine categories.
Future Research Needs For The Integration Of Mental Health Substance Abuse And Primary Care
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Author : U. S. Department of Health and Human Services
language : en
Publisher: Createspace Independent Pub
Release Date : 2013-05-14
Future Research Needs For The Integration Of Mental Health Substance Abuse And Primary Care written by U. S. Department of Health and Human Services and has been published by Createspace Independent Pub this book supported file pdf, txt, epub, kindle and other format this book has been release on 2013-05-14 with Medical categories.
Mental health problems are among the most common problems encountered by primary care providers. Half of the care for common mental disorders in the United States is delivered in general medical settings. Primary care providers commonly diagnose and manage conditions such as dysthymia, major depressive disorder, problem drinking, and anxiety disorders. Multiple challenges exist in delivering high-quality mental health care in primary care settings. The quality of the care delivered in the primary care setting may vary: providers may have difficulty making referrals when needed to mental health professionals; the supply of mental health professionals may be inadequate in some areas; and patients may be reluctant to see a second provider. Patients with serious and persistent mental illness such as schizophrenia are often seen predominantly in specialty mental health settings yet often have substantial unmet general health needs including obesity, diabetes, and cardiac risk factors, sometimes exacerbated by medication treatment of their mental illness. “Integrated care” is one approach to addressing these currently unmet needs. In integrated care models, there is systematic linkage of mental health and primary care providers requiring communication or coordination between providers to meet both the mental and general health needs of the patients. The exact nature of the consultation and collaboration varies greatly across models, and may include telephonic or information technology. Often, a mental health professional is placed, permanently or intermittently, in the primary care practice. A key difference is that the integration implies a much closer and more coordinated system of care than prior consultation or referral models. Also key is the involvement of a second health care professional, which distinguishes integrated care from interventions that train primary care providers to treat patients with mental health conditions without the involvement of a mental health professional. In 2008, the Agency for Healthcare Research and Quality (AHRQ), working with the University of Minnesota Evidence-based Practice Center (EPC), conducted a systematic review of the literature evaluating the integration of mental health and substance abuse treatment with primary care. The review addressed six key questions. The Minnesota EPC authors found 33 trials examining the impact of integrating mental health specialists into primary care; 26 trials addressed depression. The studies reported positive results for symptom severity, treatment response, and achievement of remission when compared with usual care. The level of care integration did not seem to be related to treatment outcomes. The EPC authors also reported that the level of integration did not appear to be related to outcomes. Most of the studies addressed the integration of mental health professionals into primary care; few examined the integration of primary care into mental health. A majority of the studies have involved older patients, and some positive studies, having found improved outcomes with integrated care, have been largely composed of minority populations. The main barriers identified to a broader use of integrated care include programmatic costs, insurance coverage, and relationships with multiple payers. The VA was felt to offer a good model of a sustained program. Key elements of successful models included active support at all levels of the organization and specific funding.
Integration Of Mental Health Substance Abuse And Primary Care
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Author :
language : en
Publisher:
Release Date : 2008
Integration Of Mental Health Substance Abuse And Primary Care written by and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 2008 with Mental health services categories.
Future Research Needs For The Integration Of Mental Health Substance Abuse And Primary Care
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Author :
language : en
Publisher:
Release Date : 2010
Future Research Needs For The Integration Of Mental Health Substance Abuse And Primary Care written by and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 2010 with categories.
In 2008, the Agency for Healthcare Research and Quality (AHRQ), commissioned the University of Minnesota Evidence-based Practice Center (EPC) to conduct a systematic review of the literature evaluating the integration of mental health and substance abuse treatment with primary care. The review addressed six key questions (KQ); Table A lists a summary of findings, limitations, and future recommendations. The report found substantial evidence for improved outcomes through integrated care, although most of the evidence was for treatment of depression in primary care settings. Studies reported positive results for symptom severity, treatment response, and achievement of remission when compared with usual care. The level of integration did not seem to be related to treatment outcomes. Most of the studies addressed the integration of mental health professionals into primary care; few examined the integration of primary care into mental health. The majority of the studies involved older patients. Some studies that found improved outcomes with integrated care have been largely composed of minority populations. The main barriers to a broader use of integrated care include programmatic costs, insurance coverage, and relationships with multiple payers. The U.S. Department of Veterans Affairs (VA) was shown to offer a good model of a sustained program. Key elements of successful models included active support at all levels of the organization and through specific funding. The authors of the 2008 AHRQ review (Evidence Report/Technology Assessment No. 173) identified multiple research gaps and limitations (summarized in Table ES-1), including conditions other than depression or care integration in younger populations. Other gaps included research in rural areas, examination of the use of information technology (IT), and development of financial models. One of the largest gaps was on integrating medical care into mental health care for patients with serious and persistent mental illness. In February 2010, AHRQ commissioned the RTI International-University of North Carolina at Chapel Hill Evidence-based Practice Center (RTI-UNC EPC) to work with stakeholders to develop a prioritized list of future research needs in this area that would inform researchers, funders, practitioners, advocacy groups, patients, and family members. A structured approach, including the AHRQ population, intervention, comparator, outcome, timeframe, setting (PICOTS) framework, to future research needs prioritization is new: this project, therefore, also served as a pilot for development and testing of methods to conduct such an evaluation. In the future, it is anticipated that all AHRQ-sponsored comparative effectiveness research systematic reviews will contain a documentation of future research needs.
Caring For People With Mental Health And Substance Use Disorders In Primary Care Settings
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Author : National Academies of Sciences, Engineering, and Medicine
language : en
Publisher: National Academies Press
Release Date : 2021-01-30
Caring For People With Mental Health And Substance Use Disorders In Primary Care Settings written by National Academies of Sciences, Engineering, and Medicine and has been published by National Academies Press this book supported file pdf, txt, epub, kindle and other format this book has been release on 2021-01-30 with Medical categories.
Behavioral health conditions, which include mental health and substance use disorders, affect approximately 20 percent of Americans. Of those with a substance use disorder, approximately 60 percent also have a mental health disorder. As many as 80 percent of patients with behavioral health conditions seek treatment in emergency rooms and primary care clinics, and between 60 and 70 percent of them are discharged without receiving behavioral health care services. More than two-thirds of primary care providers report that they are unable to connect patients with behavioral health providers because of a shortage of mental health providers and health insurance barriers. Part of the explanation for the lack of access to care lies in a historical legacy of discrimination and stigma that makes people reluctant to seek help and also led to segregated and inhumane services for those facing mental health and substance use disorders. In an effort to understanding the challenges and opportunities of providing essential components of care for people with mental health and substance use disorders in primary care settings, the National Academies of Sciences, Engineering, and Medicine's Forum on Mental Health and Substance Use Disorders convened three webinars held on June 3, July 29, and August 26, 2020. The webinars addressed efforts to define essential components of care for people with mental health and substance use disorders in the primary care setting for depression, alcohol use disorders, and opioid use disorders; opportunities to build the health care workforce and delivery models that incorporate those essential components of care; and financial incentives and payment structures to support the implementation of those care models, including value-based payment strategies and practice-level incentives. This publication summarizes the presentations and discussion of the webinars.
Integrating Behavioral Health And Primary Care
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Author : Dr. Robert Feinstein
language : en
Publisher: Oxford University Press
Release Date : 2017-04-13
Integrating Behavioral Health And Primary Care written by Dr. Robert Feinstein and has been published by Oxford University Press this book supported file pdf, txt, epub, kindle and other format this book has been release on 2017-04-13 with Medical categories.
Integrated care incorporates behavioral and physical health services into primary care and specialty medical environments. Integrated care models are patient-centered; delivered by teams of medical professionals, utilize care coordination, and a population-based approach. This book is practical, office-based, and comfortably accessible to students, residents, faculty, and all mental health professionals, primary care and medical specialists. We examine and recommend applying collaborative care and other existing models of integrated care based on existing literature. When there is no literature supporting a specific approach, our experts offer their ideas and take an aspirational approach about how to manage and treat specific behavioral disorder or problems We assume the use of integrated team staffing including a primary care or specialist provider(s), front desk staff, medical assistant(s), nurse(s), nurse practitioners, behavioral health specialist(s), health coaches, consulting psychiatrist, and care coordinator(s)/manager(s).
The Primary Care Toolkit
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Author : Larry James
language : en
Publisher: Springer Science & Business Media
Release Date : 2008-12-16
The Primary Care Toolkit written by Larry James and has been published by Springer Science & Business Media this book supported file pdf, txt, epub, kindle and other format this book has been release on 2008-12-16 with Psychology categories.
Integrated care is receiving a lot of attention from clinicians, administrators, policy makers, and researchers. Given the current healthcare crises in the United States, where costs, quality, and access to care are of particular concern, many are looking for new and better ways of delivering behavioral health services. Integrating behavioral health into primary care medical settings has been shown to: (1) produce healthier patients; (2) produce medical savings; (3) produce higher patient satisfaction; (4) leverage the primary care physician’s time so that they can be more productive; and (5) increase physician satisfaction. For these reasons this is an emerging paradigm with a lot of interest and momentum. For example, the President’s New Freedom Commission on Mental Health has recently endorsed redesigning the mental health system so that much of this is integrated into primary care medicine.
Evolving Models Of Behavioral Health Integration In Primary Care
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Author : Chris Collins (MSW.)
language : en
Publisher:
Release Date : 2010
Evolving Models Of Behavioral Health Integration In Primary Care written by Chris Collins (MSW.) and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 2010 with Mental health services categories.
The U.S. mental health system fails to reach and/or adequately treat the millions of Americans suffering from mental illness and substance abuse. This report offers an approach to meeting these unmet needs : the integration of primary care and behavioral health care. The report summarizes the available evidence and states' experiences around integration as a means for delivering quality, effective physical and mental health care. For those interested in integrating care, it provides eight models that represent qualitatively different ways of integrating/coordinating care across a continuum from minimal collaboration to partial integration to full integration according to stakeholder needs, resources, and practice patterns. The Milbank Memorial Fund commissioned this report to provide policymakers with a primer on integrated care that includes both a description of the various models along the continuum and a useful planning guide for those seeking to successfully implement an integrated care model in their jurisdiction.
Integrated Behavioral Health In Primary Care
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Author : Mary R. Talen
language : en
Publisher: Springer Science & Business Media
Release Date : 2013-06-04
Integrated Behavioral Health In Primary Care written by Mary R. Talen and has been published by Springer Science & Business Media this book supported file pdf, txt, epub, kindle and other format this book has been release on 2013-06-04 with Psychology categories.
Contributed by experts who’ve developed integrative healthcare initiatives with strengths in the areas of policy and principles, organizational systems, or clinical practice. These contributors will illustrate the concepts and describe the nuts and bolts of their integration initiatives. In the conclusion of each section, the editors will construct a template to systematically evaluate these essential elements. This template will organize the information to help stakeholders compare and contrast the strengths, resources, limitations and challenges of how each model meets the vision of integrative healthcare. In the concluding section the information in the preceding sections connects to provide a coherent synopsis of the common themes and practices, from the macro to micro levels of care, which foster successful integration of the medical and psychosocial systems.