Comment on “Collaborative Training Efforts with Pediatric Providers in Addressing Mental Health Problems in Primary Care”

2017 ◽  
Vol 41 (5) ◽  
pp. 617-618
Author(s):  
Michael Regalado
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Mental Health Problems ◽  
Health Problems ◽  
Collaborative Training ◽  
Pediatric Providers

Collaborative Training Efforts with Pediatric Providers in Addressing Mental Health Problems in Primary Care

2017 ◽  
Vol 41 (5) ◽  
pp. 610-616 ◽  
Author(s):  
Matthew G. Biel ◽  
Bruno J. Anthony ◽  
Laura Mlynarski ◽  
Leandra Godoy ◽  
Lee S. Beers
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Mental Health Problems ◽  
Health Problems ◽  
Collaborative Training ◽  
Pediatric Providers

Challenging care work: General practitioners’ perspectives on caring for young adults with complex psychosocial problems

2019 ◽  
pp. 136345931987410
Author(s):  
Julie Høgsgaard Andersen ◽  
Tine Tjørnhøj-Thomsen ◽  
Susanne Reventlow ◽  
Annette Sofie Davidsen
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Young Adults ◽  
General Practitioners ◽  
Mental Health Problems ◽  
Psychosocial Problems ◽  
Health Problems ◽  
Care Work ◽  
Psychiatric Nurses ◽  
Provision Of Care

The international literature shows that primary care is well placed to address mental health problems in young people, but that primary care professionals experience a range of challenges in this regard. In Denmark, young adults who have complex psychosocial problems, and who are not in education or work, cause political and academic concern. They are also in regular contact with their general practitioners, the Danish municipalities and psychiatric services. However, little is known about general practitioners’ perspectives on caring for this vulnerable group of patients. In this article, we investigate how general practitioners’ care work is shaped by the bureaucratic management of care in a complex infrastructure network comprising the general practitioners, psychiatry, the municipalities and the young adults. The analysis is based on interviews and focus groups with general practitioners, psychiatric nurses and social workers. We employ Tronto’s concept of care and the concept of boundary work as a theoretical framework. We argue that general practitioners strive to provide care, but they are challenged by the following: contested diagnostic interpretations and the bureaucratic significance of diagnoses for the provision of care from psychiatry and the municipalities, systemic issues with handling intertwined social and mental health problems, and the young adults’ difficulties with accessing and receiving available care.

scholarly journals Impact of mental health and addiction NIMHANS ECHO on primary care physicians: study from a rural state of India

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S157-S157
Author(s):  
Shabinabegam A M Sheth ◽  
Bhavya Bairy ◽  
Aurobind Ganesh ◽  
Sumi Jain ◽  
Prabhat Chand ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Health Care Providers ◽  
Mental Health Problems ◽  
Health Problems ◽  
Care Providers ◽  
Primary Health ◽  
Secondary Outcomes

AimsAs per National Mental Health Survey-2015-16, 83 out of 100 people having mental health problems do not have access to care in India. Further, primary health care providers (PCPs) have not been adequately trained in the screening, diagnosis, and initial management of common mental health conditions. There is thus a need to train health care providers at the State level to incorporate mental health into primary health care. In this paper, we report the findings of a collaborative project between the National Institute of Mental Health and Neuro Sciences (NIMHANS) Bangalore India, and the state of Chhattisgarh incorporating mental health into primary care and addressing urban-rural disparities through tele-mentoring.MethodWe assessed the impact of the NIMHANS Extended Community Health Care Outcome (ECHO), an online, blended training program on participants' knowledge and competence (primary outcome) and commitment, satisfaction, and performance (Secondary outcomes) using Moore's evaluation framework. Primary and secondary outcomes were determined through a pre-post evaluation, assessment of trainee participation in the quarterly tele ECHO clinic as well as periodic assignments, respectively.ResultOver ten months of the NIMHANS ECHO program, there was a significant improvement in the participants' knowledge post-ECHO (p < 0.05, t = −3.52). Self-efficacy in diagnosis and management of mental health problems approached significance; p < 0.001. Increased engagement in tele-ECHO sessions was associated with better performance for declarative and procedural knowledge. The attrition rate was low (5 out of 30 dropped out), and satisfaction ratings of the course were high across all fields. The participants reported a 10- fold increase in the number of patients with mental health problems they had seen, following the training. A statistically significant increase in the number of psychotropic drugs prescribed post ECHO with t = −3.295, p = 0.01.ConclusionThe outcomes indicate that the NIMHANS ECHO with high participant commitment is a model with capacity building potential in mental health and addiction for remote and rural areas by leveraging technology. This model has the potential to be expanded to other states in the country in providing mental health care to persons in need of care.

Primary Care Pediatrics and Child Psychopathology: A Review of Diagnostic, Treatment, and Referral Practices

PEDIATRICS ◽  
1986 ◽  
Vol 78 (6) ◽  
pp. 1044-1051 ◽  
Author(s):  
Elizabeth J. Costello
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Health Care ◽  
Mental Disorder ◽  
Mental Health Care ◽  
Mental Health Problems ◽  
Primary Care Providers ◽  
Health Problems ◽  
Group Practices ◽  
Primary Care Pediatricians

The quality of mental health care for children depends not only on specialist mental health services, but also on how effectively primary care providers identify, treat, and refer children with emotional and behavioral problems. Recent research has shown that primary care practitioners are the sole providers of mental health care to the majority of people with a mental disorder. For example, Regier et al1 calculated that in 1975 54.1% of persons with a mental disorder were treated only in a primary care or outpatient medical setting, with another 6% receiving care from both specialist mental health and primary care medical facilities. An additional 21.5% were not in treatment or received treatment from nonmedical agencies. If the data were extrapolated for all age groups, these rates would imply that only one child in five with a mental disorder is receiving specialist treatment, three are in the care of a pediatrician, and one is receiving no treatment. This would lead to the conclusion that pediatricians are, according to Regier et al,1 the de facto mental health service for most children in need of such care. It would lend support to the drive to increase pediatricians' awareness of, and training for, the mental health component of their work.2 In this paper, we review the published evidence as it applies to children. SCOPE This review includes the published studies of mental health problems diagnosed by primary care pediatricians, family practitioners, or pediatric nurse practitioners working in outpatient settings in the United States. These include private pediatric practices, group practices, health maintenance organizations (HMOs), and other types of prepaid group practices. The questions addressed are: (1) What proportion of the children seen by primary care pediatricians and their colleagues are diagnosed by them as having a mental disorder? (2) What proportion of children are referred for specialist evaluation and treatment? (3) What risk factors are associated with a higher probability of receiving a diagnosis of psychopathology? (4) How accurate are primary care pediatricians' diagnoses of mental health problems?

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