Training in Integrated Mental Health-Primary Care Models: A National Survey of Child Psychiatry Program Directors

Psychiatric disorders are becoming more frequently diagnosed within the pediatric primary care setting. Despite increased diagnosis within primary care, only a minority of patients receive further psychiatric or specialty care. The integrated/collaborative care treatment model was designed to improve access within primary care. The purpose of this review is to identify randomized controlled trials and quasi-experimental studies that have investigated whether increased access improves treatment engagement, satisfaction, and improved mental health outcomes. Six studies met inclusion criteria. Studies reviewed indicated increased access to behavioral health treatment through use of the integrated/collaborative care model and improved mental health outcomes. Recommendations for screening and treatment are provided. Limitations of the reviewed studies include lack of generalizability to urban populations, minority youth, and youth younger than 4 years of age. Practice recommendations to address these limitations are identified.

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Improving medical residents’ utilisation of integrated mental health in primary care

BMJ Open Quality ◽

10.1136/bmjoq-2021-001388 ◽

2021 ◽

Vol 10 (3) ◽

pp. e001388

Author(s):

Jenna Palladino ◽

Deirdra Frum-Vassallo ◽

Joanne D Taylor ◽

Victoria L Webb

Keyword(s):

Mental Health ◽

Primary Care ◽

Mental Health Services ◽

Health Services ◽

Medical Home ◽

Medical Resident ◽

Improvement Project ◽

Mental Health Integration ◽

Integrated Mental Health ◽

Over Time

BackgroundIntegration of mental health services allows for improved prevention and management of chronic conditions within the primary care setting. This quality improvement project aimed to increase adherence to and functioning of an integrated care model within a patient-centred medical home. Specifically, the project focused on improving collaboration between Primary Care Mental Health Integration (PC-MHI) and the medical resident Patient Aligned Care Teams (PACT) at a Veterans Affairs Medical Center in Northport,New York (VAMC Northport).MethodThe project used increased education, training and relationship building among the medical resident PACTs, and the establishment of regularly occurring integrated team meetings for medical and mental health providers. Education of residents was measured with a self-assessment pre-training and post-training, while utilisation was measured by the percentage of patients currently on a PACT’s panel with at least one PC-MHI encounter in the last 12 months (known in VAMC Northport as PACT-15 metric).ResultsTwo resident PACTs that received both training and weekly integrated meetings increased their utilisation of integrated mental health services by 3.8% and 4.5%, respectively. PACTs that participated in training only, with no regular meetings, showed an initial improvement in utilisation that declined over time.ConclusionsTraining alone appeared beneficial but insufficient for increased integration over time. The addition of a regularly occurring integrated weekly meeting may be a critical component of facilitating sustained mental health integration in a primary care medical home model.

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The Experience of Primary Care Providers With an Integrated Mental Health Care Program in Safety-Net Clinics

Family & Community Health ◽

10.1097/fch.0000000000000067 ◽

2015 ◽

Vol 38 (2) ◽

pp. 158-168 ◽

Cited By ~ 6

Author(s):

Wayne D. Bentham ◽

Anna Ratzliff ◽

David Harrison ◽

Ya-Fen Chan ◽

Steven Vannoy ◽

...

Keyword(s):

Mental Health ◽

Primary Care ◽

Health Care ◽

Care Program ◽

Primary Care Providers ◽

Safety Net ◽

Care Providers ◽

Health Care Program ◽

Safety Net Clinics ◽

Integrated Mental Health

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Development and piloting of a plan for integrating mental health in primary care in Sehore district, Madhya Pradesh, India

The British Journal of Psychiatry ◽

10.1192/bjp.bp.114.153700 ◽

2016 ◽

Vol 208 (s56) ◽

pp. s13-s20 ◽

Cited By ~ 32

Author(s):

Rahul Shidhaye ◽

Sanjay Shrivastava ◽

Vaibhav Murhar ◽

Sandesh Samudre ◽

Shalini Ahuja ◽

...

Keyword(s):

Mental Health ◽

Primary Care ◽

Mental Disorders ◽

Action Plan ◽

Mental Healthcare ◽

Theory Of Change ◽

World Health ◽

Care Workers ◽

Care Models ◽

Health Organization

BackgroundThe large treatment gap for mental disorders in India underlines the need for integration of mental health in primary care.AimsTo operationalise the delivery of the World Health Organization Mental Health Gap Action Plan interventions for priority mental disorders and to design an integrated mental healthcare plan (MHCP) comprising packages of care for primary healthcare in one district.MethodMixed methods were used including theory of change workshops, qualitative research to develop the MHCP and piloting of specific packages of care in a single facility.ResultsThe MHCP comprises three enabling packages: programme management, capacity building and community mobilisation; and four service delivery packages: awareness for mental disorders, identification, treatment and recovery. Challenges were encountered in training primary care workers to improve identification and treatment.ConclusionsThere are a number of challenges to integrating mental health into primary care, which can be addressed through the injection of new resources and collaborative care models.

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Promoting Access Through Integrated Mental Health Care Education

The Open Nursing Journal ◽

10.2174/187443460160101073 ◽

2016 ◽

Vol 10 (1) ◽

pp. 73-77 ◽

Cited By ~ 1

Author(s):

Karan Kverno

Keyword(s):

Mental Health ◽

Primary Care ◽

Health Care ◽

Mental Health Care ◽

Nurse Practitioners ◽

Care Nurse ◽

Primary Care Nurse ◽

Mental Health Nurse ◽

Health Nurse ◽

Integrated Mental Health

Mental disorders are the leading cause of non-communicable disability worldwide. Insufficient numbers of psychiatrically trained providers and geographic inequities impair access. To close this treatment gap, the World Health Organization (WHO) has called for the integration of mental health services with primary care. A new innovative online program is presented that increases access to mental health education for primary care nurse practitioners in designated mental health professional shortage areas. To create successful and sustainable change, an overlapping three-phase strategy is being implemented. Phase I is recruiting and educating primary care nurse practitioners to become competent and certified psychiatric mental health nurse practitioners. Phase II is developing partnerships with state and local agencies to identify and support the psychiatric mental health nurse practitioner education and clinical training. Phase III is sustaining integrated mental health care services through the development of nurse leaders who will participate in interdisciplinary coalitions and educate future students.

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Treatment Initiation Following Positive Depression Screens in Primary Care: a Propensity Score–Weighted Analysis of Integrated Mental Health Services

Journal of General Internal Medicine ◽

10.1007/s11606-020-05694-5 ◽

2020 ◽

Author(s):

Brittany L. Cornwell ◽

Benjamin R. Szymanski ◽

Kipling M. Bohnert ◽

John F. McCarthy

Keyword(s):

Mental Health ◽

Primary Care ◽

Mental Health Services ◽

Propensity Score ◽

Health Services ◽

Treatment Initiation ◽

Weighted Analysis ◽

Integrated Mental Health

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Understanding Mental Health System Governance in India: Perspectives of Key Stakeholders

10.20944/preprints202005.0276.v1 ◽

2020 ◽

Cited By ~ 1

Author(s):

Shalini Ahuja ◽

Rahul Shidhaye ◽

Azaz Khan ◽

Tessa Roberts ◽

Mark Jordans ◽

...

Keyword(s):

Mental Health ◽

Primary Care ◽

Health Care ◽

Health System ◽

Health Service Delivery ◽

System Component ◽

Structured Interviews ◽

Health Care Planning ◽

Mental Health Service Delivery ◽

Integrated Mental Health

Introduction: Governance, the least studied health system component, comprises a system of rules and processes, and is a key determinant for effective decision making for health care planning. This study aims to identify institutional, legal and policy factors which are either barriers or facilitators for the implementation of integrated mental health in primary care in the India. Methods: Semi-structured interviews were conducted with 33 key informants at the district and national levels with policy makers, state level health care planners and district planners and managers in India. The data were analysed using thematic analysis using the qualitative software NViVO 10. Findings: Participants stated that a conducive environment for mental health service delivery is necessary at the legislative, policy and planning levels, to facilitate integration of mental health into primary care. Amongst other factors, the need for active involvement of civil society and service user organisations, strengthening mental health information systems, and building the non-technical skills of the mental health workforce, were identified as particularly necessary to deliver adequate mental health services.Conclusion: Amidst the favourable policy context supporting collaborative and integrated care in India, this study identified low resourcing, weak collaborations and inadequate information to be crucial for integrated mental health in India at present.

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