Primary Care Medical Provider Attitudes Regarding Mental Health and Behavioral Medicine in Integrated and Non-integrated Primary Care Practice Settings

2012 ◽  
Vol 19 (4) ◽  
pp. 364-375 ◽  
Author(s):  
Abbie O. Beacham ◽  
Andrew Herbst ◽  
Timothy Streitwieser ◽  
Elizabeth Scheu ◽  
William J. Sieber
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Behavioral Medicine ◽  
Primary Care Practice ◽  
Integrated Primary Care ◽  
Care Practice ◽  
Medical Provider ◽  
Provider Attitudes

Mental Health Care of Children and Adolescents: A Guide for Primary Care Clinicians

2018 ◽  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Health Care ◽  
Mental Health Care ◽  
Children And Adolescents ◽  
Primary Care Practice ◽  
Care Practice ◽  
Primary Care Clinicians

This indispensable resource provides vital guidance for integrating mental health care into your everyday primary care practice. https://shop.aap.org/mental-health-care-of-children-and-adolescents-a-guide-for-primary-care-clinicians-paperback/

scholarly journals Potential for Integrating Mental Health Specialist Video Consultations in Office-Based Routine Primary Care: Cross-Sectional Qualitative Study Among Family Physicians

10.2196/13382 ◽  
2019 ◽  
Vol 21 (8) ◽  
pp. e13382 ◽  
Author(s):  
Mariell Hoffmann ◽  
Mechthild Hartmann ◽  
Michel Wensing ◽  
Hans-Christoph Friederich ◽  
Markus W Haun
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Qualitative Study ◽  
Primary Care Practice ◽  
Family Physicians ◽  
Health Conditions ◽  
Care Practice ◽  
Cross Sectional ◽  
Mental Health Specialist ◽  
Health Specialist

Background Although real-time mental health specialist video consultations have been proposed as an effective care model for treating patients with mental health conditions in primary care, little is known about their integration into routine practice from the perspective of family physicians. Objective This study aimed to determine the degree to which family physicians advocate that mental health specialist video consultations can be integrated into routine primary care, where most patients with mental health conditions receive treatment. Methods In a cross-sectional qualitative study, we conducted 4 semistructured focus groups and 3 telephonic interviews in a sample of 19 family physicians from urban and rural districts. We conducted a qualitative content analysis applying the Tailored Implementation in Chronic Diseases framework in a combined bottom-up (data-driven) and top-down strategy for deriving key domains. Results Family physicians indicated that mental health specialist video consultations are a promising and practical way to address the most pressing challenges in current practice, that is, to increase the accessibility and co-ordination of specialized care. Individual health professional factors were the most frequently discussed topics. Specifically, family physicians valued the anticipated clinical outcomes for patients and the anticipated resources set for the primary care practice as major facilitators (16/19, 84%). However, family physicians raised a concern regarding a lack of facial expressions and physical interaction (19/19, 100%), especially in emergency situations. Therefore, most family physicians considered a viable emergency plan for mental health specialist video consultations that clearly delineates the responsibilities and tasks of both family physicians and mental health specialists to be essential (11/19, 58%). Social, political, and legal factors, as well as guideline factors, were hardly discussed as prerequisites for individual family physicians to integrate mental health specialist video consultations into routine care. To facilitate the implementation of future mental health specialist video consultation models, we compiled a checklist of recommendations that covers (1) buy-in from practices (eg, emphasizing logistical and psychological relief for the practice), (2) the engagement of patients (eg, establishing a trusted patient-provider relationship), (3) the setup and conduct of consultations (eg, reliable emergency plans), and (4) the fostering of collaboration between family physicians and mental health specialists (eg, kick-off meetings to build trust). Conclusions By leveraging the primary care practice as a familiar environment for patients, mental health specialist video consultations provide timely specialist support and potentially lead to benefits for patients and more efficient processes of care. Integration should account for the determinants of practice as described by the family physicians. Trial Registration German Clinical Trials Register DRKS00012487; https://www.drks.de/drks_web/navigate.do? navigationId=trial.HTML&TRIAL_ID=DRKS00012487

scholarly journals An audit of risk assessments and management for self-harm and suicide in patients with depressive symptoms at a primary care practice in the UK

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S89-S89
Author(s):  
Win Let Oo
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Depressive Symptoms ◽  
Primary Care Practice ◽  
Significant Risk ◽  
Care Practice ◽  
Nice Guidelines ◽  
Increased Risk ◽  
Self Harm ◽  
The Impact

AimsOver 5 million adults in England are living with depression, with the highest prevalence rates recorded in the North West and North East of England, 12.88% and 11.53%, respectively (NHS Digital, 2019). Depression is also associated with the highest rates of self-harm and suicide (SH&S) (Singhal, Ross, Seminog, Hawton, & Goldarce, 2014). The impact of SH&S on a family ranges from shock and horror to, blame, secrecy and shame. Survivors may also be negatively judged or self-stigmatise (Cerel, Jordan, & Duberstein, 2008). Managing self-harm episodes has a significant financial implication for the NHS (Tsiachristas, et al., 2017). If high-risk individuals are identified and intervened early, it would not only save lives but also potentially reduce financial strains. The aim of the audit is to evaluate the performance of risk assessment and management of self-harm and suicide at the Reedyford Healthcare Group, Nelson, England, and to determine whether the primary care practice is meeting the standards of the National Institute for Health and Care Excellence (NICE) guidelines for adults with depression.MethodA retrospective audit of 62 patients presenting with depressive symptoms over 3 months was performed at the Reedyford Healthcare Group.Two criteria from the NICE guidelines for adults with depression were included with associated standards of 100%:All patients with depression should be assessed for suicidal ideation and intent by asking direct questions.A patient presenting with significant risk to self/others should be referred to specialist mental health services the same day, as soon as possible.Result42 patients were asked direct questions about SH&S. 2 patients presenting with immediate risk were urgently referred to specialist services. Nonetheless, all those patients at increased risk of suicide were given an increased level of support by the practice. The results indicated that the practice could improve, and a quality improvement approach has been planned.ConclusionThe assessment of risk in patients presenting with depression is vital. This audit shows that it is not always done in practice. The author has not found other published audits on this topic and suggests that this may be appropriate for a national audit. This is particularly prudent with the current concern regarding mental health in the COVID-19 pandemic.

Enhancing Pediatric Mental Health Care: Strategies for Preparing a Primary Care Practice

PEDIATRICS ◽  
2010 ◽  
Vol 125 (Supplement 3) ◽  
pp. S87-S108 ◽  
Author(s):  
Jane Meschan Foy ◽  
Kelly J. Kelleher ◽  
Danielle Laraque ◽  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Health Care ◽  
Mental Health Care ◽  
Primary Care Practice ◽  
Care Practice ◽  
Health Care Strategies ◽  
Pediatric Mental Health

scholarly journals eHealth-supported case management for patients with panic disorder or depression in primary care: Study protocol for a cRCT (PREMA)

Trials ◽  
2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Karoline Lukaschek ◽  
◽  
Karola Mergenthal ◽  
Dirk Heider ◽  
Alexander Hanke ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Case Management ◽  
Cognitive Behaviour Therapy ◽  
Primary Care Practice ◽  
Care Practice ◽  
Behaviour Therapy ◽  
Treatment As Usual ◽  
Cognitive Behaviour

Abstract Background Panic disorder (PD), frequently occurring with agoraphobia (AG), and depression are common mental disorders in primary care and associated with considerable individual and societal costs. Early detection and effective treatment of depression and PD/AG are of major importance. Cognitive behavioural exposure exercises have been shown to be effective in reducing anxiety and depressive symptoms. Practice team-based case management can improve clinical outcomes for patients with chronic diseases in primary care. The present study aims at evaluating the effects and cost-effectiveness of a primary care team-based intervention using behavioural therapy elements and case management supported by eHealth components in patients with PD/AG or depression compared to treatment as usual. Methods/design This is a two-arm cluster-randomized, controlled trial (cRCT). General practices represent the units of randomisation. General practitioners recruit adult patients with depression and PD ± AG according to the International Classification of Diseases, version 10 (ICD-10). In the intervention group, patients receive cognitive behaviour therapy-oriented psychoeducation and instructions to self-managed exposure exercises in four manual-based appointments with the general practitioner. A trained health care assistant from the practice team delivers case management and is continuously monitoring symptoms and treatment progress in ten protocol-based telephone contacts with patients. Practice teams and patients are supported by eHealth components. In the control group, patients receive usual care from general practitioners. Outcomes are measured at baseline (T0), at follow-up after 6 months (T1), and at follow-up after 12 months (T2). The primary outcome is the mental health status of patients as measured by the Mental Health Index (MHI-5). Effect sizes of 0.2 standard deviation (SD) are regarded as relevant. Assuming a drop-out rate of 20% of practices and patients each, we aim at recruiting 1844 patients in 148 primary care practices. This corresponds to 12.5 patients on average per primary care practice. Secondary outcomes include depression and anxiety-related clinical parameters and health-economic costs. Discussion If the intervention is more effective than treatment as usual, the three-component (cognitive behaviour therapy, case-management, eHealth) primary care-based intervention for patients suffering from PD/AG or depression could be a valuable low-threshold option that benefits patients and primary care practice teams. Trial registration German clinical trials register, DRKS00016622. Registered on February 22nd, 2019.

Mental Health in Primary Care Training and Practice: An Innovative Approach

1979 ◽  
Vol 9 (1) ◽  
pp. 49-60 ◽  
Author(s):  
George L. Adams ◽  
Charles C. Cheney ◽  
Michael P. Tristan ◽  
Janice Friese ◽  
Laurence R. Schweitzer
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Mental Health Professionals ◽  
Primary Care Physicians ◽  
Primary Care Practice ◽  
Care Practice ◽  
Mental Health Training ◽  
Working Definition ◽  
Innovative Program ◽  
Definition Of

The need to augment the number of primary care physicians throughout the nation has been well documented. Moreover, there is increasing recognition of the importance of mental health in primary care practice. The authors present a working definition of primary care practice, discuss the role of mental health in primary care, and describe an innovative program developed in Houston which integrates primary care mental health training into the education of primary care physicians and mental health professionals.

Medical provider attitudes about behavioral health consultants in integrated primary care: A preliminary study.

2014 ◽  
Vol 32 (4) ◽  
pp. 426-432 ◽  
Author(s):  
Nicole D. Torrence ◽  
Anne E. Mueller ◽  
Allison A. Ilem ◽  
Brenna N. Renn ◽  
Brian DeSantis ◽  
...  
Keyword(s):  
Primary Care ◽  
Behavioral Health ◽  
Integrated Primary Care ◽  
Medical Provider ◽  
Provider Attitudes ◽  
Preliminary Study
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