scholarly journals 38. Understanding Variations In Primary Care Providers’ Perceptions And Practices In Implementing Confidential Sexual Health Services For Adolescents

2019 ◽  
Vol 64 (2) ◽  
pp. S20-S21
Author(s):  
Renee E. Sieving ◽  
Christopher J. Mehus ◽  
Marina Catallozzi ◽  
Stephanie A. Grilo ◽  
Annie-Laurie McRee ◽  
...  
2005 ◽  
Vol 3 (1) ◽  
pp. 13-29 ◽  
Author(s):  
Hongtu Chen ◽  
Elizabeth Kramer ◽  
Teddy Chen ◽  
Jianping Chen ◽  
Henry Chung

Compared to all other racial and ethnic groups, Asian Americans have the lowest utilization of mental health services. Contributing factors include extremely low community awareness about mental health, a lack of culturally competent Asian American mental health professionals, and severe stigma associated with mental illness. This manuscript describes an innovative program that bridges the gap between primary care and mental health services. The Bridge Program, cited in the supplement to the Surgeon’s General’s Report on Mental Health: Culture, Race, and Ethnicity as a model for delivery of mental health services through primary care; (2) to improve capacity by enhancing the skills of primary care providers to identify and treat mental disorders commonly seen in primary care; and (3) to raise community awareness by providing health education on mental health and illness. Results are presented and the potential for replication is addressed.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 10-11
Author(s):  
Victoria Grando ◽  
Roy Grando

Abstract In recent years, FNPs have been challenged to deliver mental health services in the primary care setting. Over half of mental health services are provided in primary care, and one-quarter of all primary care patients have a mental disorder. Moreover, 20% of older adults have a mental or neurological disorder often not diagnosed. Nationally, it is estimated that 17% of older adults commit suicide, 15% have a mental condition, 11% have dementia, and 5% have a serious mental condition. There is a paucity of adequately prepared primary care providers trained in geropsychiatric treatment. A didactic course was developed to instruct FNP students in the skills needed to provide mental health treatment in primary care. We discuss mental illness in the context of culture to ensure that treatment is congruent with a patient’s unique cultural background and experiences. This shapes the patients’ beliefs and behaviors that influence the way they view their condition and what they perceive as acceptable solutions. We then go into detail about the common mental conditions that older adults exhibit. Through the case study method, students learn to identify the presenting problem, protocols for analyzing the case, which includes making differential diagnoses and a treatment plan including initial medications, non-medical treatments, and referral. Students are introduced to the DMS-5 to learn the criteria for mental health diagnosis with an emphasis on suicide, depressive disorders, anxiety disorders, bipolar disorders, substance use disorders, and neurocognitive disorders. We have found that students most often misdiagnose neurocognitive disorders.


2015 ◽  
Vol 34 (2) ◽  
pp. 63-72 ◽  
Author(s):  
Graham Gaylord ◽  
S. Kathleen Bailey ◽  
John M. Haggarty

This study describes a shared mental health care (SMHC) model introduced in Northern Ontario and examines how its introduction affected primary care provider (PCP) mental health referral patterns. A chart review examined referrals (N = 4,600) from 5 PCP sites to 5 outpatient community mental health services from January 2001 to December 2005. PCPs with access to SMHC made significantly more mental health referrals (p < 0.001). Two demographically similar PCPs were then compared, one co-located with SMHC. Referrals for depression to non-SMHC mental health services were 1.69 times more likely to be from the PCP not co-located with SMHC (p < 0.001). Findings suggest SMHC increases access to care and decreases demand on existing mental health services.


2019 ◽  
Vol 7 (2) ◽  
pp. e000057 ◽  
Author(s):  
Melissa DeJonckheere ◽  
Lisa M Vaughn

Semistructured in-depth interviews are commonly used in qualitative research and are the most frequent qualitative data source in health services research. This method typically consists of a dialogue between researcher and participant, guided by a flexible interview protocol and supplemented by follow-up questions, probes and comments. The method allows the researcher to collect open-ended data, to explore participant thoughts, feelings and beliefs about a particular topic and to delve deeply into personal and sometimes sensitive issues. The purpose of this article was to identify and describe the essential skills to designing and conducting semistructured interviews in family medicine and primary care research settings. We reviewed the literature on semistructured interviewing to identify key skills and components for using this method in family medicine and primary care research settings. Overall, semistructured interviewing requires both a relational focus and practice in the skills of facilitation. Skills include: (1) determining the purpose and scope of the study; (2) identifying participants; (3) considering ethical issues; (4) planning logistical aspects; (5) developing the interview guide; (6) establishing trust and rapport; (7) conducting the interview; (8) memoing and reflection; (9) analysing the data; (10) demonstrating the trustworthiness of the research; and (11) presenting findings in a paper or report. Semistructured interviews provide an effective and feasible research method for family physicians to conduct in primary care research settings. Researchers using semistructured interviews for data collection should take on a relational focus and consider the skills of interviewing to ensure quality. Semistructured interviewing can be a powerful tool for family physicians, primary care providers and other health services researchers to use to understand the thoughts, beliefs and experiences of individuals. Despite the utility, semistructured interviews can be intimidating and challenging for researchers not familiar with qualitative approaches. In order to elucidate this method, we provide practical guidance for researchers, including novice researchers and those with few resources, to use semistructured interviewing as a data collection strategy. We provide recommendations for the essential steps to follow in order to best implement semistructured interviews in family medicine and primary care research settings.


Author(s):  
Dan Chateau ◽  
Alan Katz ◽  
Chelsey McDougall ◽  
Carole Taylor ◽  
Scott McCulloch

IntroductionPopulation based data on the social determinants of health are not widely available, despite a wide body of evidence pointing to their importance. The Mantioba Population Research Data Repository offers a unique opportunity to leverage data from multiple government departments to assess the relationship between measurable social determinants and health. Objectives and ApproachUsing population based data from health, small area level census survey questions, social assisitance, education, social housing, child protective services and justice, linked at the individual level, we measured indicators of social complexity and mapped them in the province of Manitoba. Individuals with high level of social complexity were then compared with indicators of medical complexity and/or high use of medical services to determine the degree of overlap between these attributes of individuals. A matched group of individuals without any of the measured social complexities was developed and the number and reason for visits to primary care providers was compared. ResultsThe rate of individuals having three or more social complexities varied from a low of ~7% to a high of 35%, depending on the geographic location. High residential mobiity, involvement with the justice system and history of social assistance were the most frequent (>15%). Individuals with social complexities tended to be younger and live in poorer neighbourhoods than medically complex individuals or high users of health services. Socially complex persons had on average 5.5 primary care visits annually, compared to only ~3.5 for matched individuals with no social complexities. The overlap with high users of health services was slight (14.4%) and depended on the characteristics of the population. The overlap with medically complex patients ws higher (16.2%), particularly when medical complexity included mental health related diagnoses (20.4%). Conclusion/ImplicationsThe proportion of individuals with social complexities is large, and a substantial number have multiple risk factors. These individuals are for the most part a unique group, distinct from medically complex patients. Different strategies for care may be necessary to promote and sustain mental and physical health and wellbeing.


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