scholarly journals The Critical Role of Primary Care Providers in Meeting Mental Health Care Needs in 2021

2021 ◽  
Vol 17 (1) ◽  
pp. 3-4
Author(s):  
Susie M. Adams ◽  
Dawn M. Vanderhoef
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Health Care ◽  
Mental Health Care ◽  
Critical Role ◽  
Primary Care Providers ◽  
Health Care Needs ◽  
Care Providers ◽  
Care Needs

754 Insomnia and Depression Symptoms in Primary Care Patients Referred for Mental Health Care

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A294-A294
Author(s):  
Ivan Vargas ◽  
Alexandria Muench ◽  
Mark Seewald ◽  
Cecilia Livesey ◽  
Matthew Press ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Health Care ◽  
Mental Health Care ◽  
Primary Care Providers ◽  
Depression Symptoms ◽  
Care Providers ◽  
Mild Depression ◽  
Significant Depression ◽  
Clinically Significant

Abstract Introduction Past epidemiological research indicates that insomnia and depression are both highly prevalent and tend to co-occur in the general population. The present study further assesses this association by estimating: (1) the concurrence rates of insomnia and depression in outpatients referred by their primary care providers for mental health care; and (2) whether the association between depression and insomnia varies by insomnia subtype (initial, middle, and late). Methods Data were collected from 3,174 patients (mean age=42.7; 74% women; 50% Black) who were referred to the integrated care program for assessment of mental health symptoms (2018–2020). All patients completed an Insomnia Severity Index (ISI) and a Patient Health Questionnaire (PHQ-9) during their evaluations. Total scores for the ISI and PHQ-9 were computed. These scores were used to categorize patients into diagnostic groups for insomnia (no-insomnia [ISI < 8], subthreshold-insomnia [ISI 8–14], and clinically-significant-insomnia [ISI>14]) and depression (no-depression [PHQ-914]). Items 1–3 of the ISI were also used to assess the association between depression and subtypes of insomnia. Results Rates of insomnia were as follows: 34.6% for subthreshold-insomnia, 35.5% for clinically-significant insomnia, and 28.9% for mild-depression and 26.9% for clinically-significant-depression. 92% of patients with clinically significant depression reported at least subthreshold levels of insomnia. While the majority of patients with clinical depression reported having insomnia, the proportion of patients that endorsed these symptoms were comparable across insomnia subtypes (percent by subtype: initial insomnia 63%; middle insomnia 61%; late insomnia 59%). Conclusion According to these data, the proportion of outpatients referred for mental health evaluations that endorse treatable levels of insomnia is very high (approximately 70%). This naturally gives rise to at least two questions: how will such symptomatology be addressed (within primary or specialty care) and what affect might targeted treatment for insomnia have on health were it a focus of treatment in general? Support (if any) Vargas: K23HL141581; Perlis: K24AG055602

Introducing Shared Mental Health Care in Northwestern Ontario: An Analysis of Changing Referral Patterns of Primary Care Providers

2015 ◽  
Vol 34 (2) ◽  
pp. 63-72 ◽  
Author(s):  
Graham Gaylord ◽  
S. Kathleen Bailey ◽  
John M. Haggarty
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Health Care ◽  
Mental Health Services ◽  
Health Services ◽  
Mental Health Care ◽  
Community Mental Health Services ◽  
Primary Care Providers ◽  
Care Providers ◽  
Referral Patterns

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.

Home-Based Care and Primary Care Settings for Delivery of Geropsychology Services to Older Persons

2019 ◽  
Author(s):  
Srijana Shrestha
Keyword(s):  
Mental Health ◽  
Older Adults ◽  
Primary Care ◽  
Health Care ◽  
Mental Health Care ◽  
Primary Care Providers ◽  
Mental Illnesses ◽  
Care Providers ◽  
Primary Care Clinics ◽  
Home Based

Despite high rates of mental illnesses, older adults face multiple barriers in accessing mental health care. Primary care clinics, and home- and community-based senior-serving agencies are settings where older adults routinely receive medical care and social services. Therefore, integration of mental health care with existing service delivery systems can improve access to mental health services and reduce the unmet mental health needs of seniors. Evidence suggests that with innovative components mental health provided in collaboration with primary care providers with or without co-location within primary care clinics can improve depression and anxiety. Home-based models for depression care are also effective, but more research is needed in examining home-based approaches in late-life anxiety treatment. It is noteworthy that integrative models are particularly helpful in expanding the reach in underserved communities: elders from minority and low-income backgrounds and homebound seniors.

Mental Health Navigation – a Model

2019 ◽  
Vol 35 (1) ◽  
pp. 151-159
Author(s):  
Gerald Knesek ◽  
Thomas Hemphill
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Conceptual Model ◽  
Health Care Services ◽  
Health Care Needs ◽  
Care Needs ◽  
Care Services ◽  
Whole Person

Summary The need for mental health care services is a growing concern around the world. This article proposes a conceptual model for the role a mental health care navigator to meet the growing needs of consumers who are seeking greater access to fragmented and confusing mental health care services. This conceptual model proposes integrating mental health into primary care with a more patient-centered approach to the care of the whole person. This approach is congruent with The Ottawa Charter for Health Promotion Charter calling for the reorienting of health services focusing on the total needs of the individual as a whole person. Although USA focused, the model has potential for sharing across countries to build capacity for mental health care in other countries around the world. The conceptual model focuses on matching consumer mental health care needs with the correct mental health care services. This would ensure that patients get the appropriate mental health care services while allowing the primary care physician to maintain the role of coordinator of care for all of the patient’s health care needs. The main intent of the model is to stimulate discussion and exploration around the role of a proposed mental health care navigator that can lead to creating models reflecting local need and adaptation. Successful models can lead to collaborative discussion encouraging capacity building in other countries. The authors maintain that coordination of health care, including mental, medical and surgical care, is the best approach to controlling costs and ensuring the health of the whole person.

Postpartum emotional support: a qualitative study of women’s and men’s anticipated needs and preferred sources

2013 ◽  
Vol 19 (1) ◽  
pp. 46 ◽  
Author(s):  
Heather J. Rowe ◽  
Sara Holton ◽  
Jane R. W. Fisher
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Health Care ◽  
Mental Health Care ◽  
Emotional Support ◽  
Family Care ◽  
Late Pregnancy ◽  
Primary Care Providers ◽  
Public Understanding ◽  
Care Providers

Australian health policy emphasises prevention, early intervention and improved pathways to treatment for perinatal mental disorders. Primary care is vital to achieving these aims. The aim of this study was to understand the anticipated needs and preferred sources of mental health information and support of men and women expecting their first baby. Nulliparous English-speaking expectant parents attending childbirth education programs in public and private hospitals participated in single sex small group discussions in late pregnancy. Discussions were audio-recorded, transcribed and analysed thematically using the group as the unit of analysis. Eight groups (22 women; 16 men) encompassing diverse socioeconomic circumstances were conducted. Analyses showed idealised fantasies consistently tempered with realistic expectations about adjustment to life with a baby. However, there were diverse and gendered views about whether primary care providers should discuss mental health with parents of infants and willingness to complete written questionnaires or be referred for specialist mental health care. Men regard primary family care as mother not father inclusive. Expectant parents readily anticipate realistic postnatal adjustment and need for emotional support. Increased provision of services that meet men’s needs and public understanding and acceptance of Australian integrated models of primary postnatal mental health care are needed.

“Why Should I Tell My Business?”: An Emerging Theory of Coping and Disclosure in Teens

2016 ◽  
Vol 30 (2) ◽  
pp. 124-142 ◽  
Author(s):  
Daniela T. DeFrino ◽  
Monika Marko-Holguin ◽  
Stephanie Cordel ◽  
Lauren Anker ◽  
Melishia Bansa ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Health Care ◽  
Mental Health Care ◽  
Health Care Services ◽  
Primary Care Providers ◽  
Care Providers ◽  
Care Services ◽  
Constant Comparative Analysis ◽  
To Receive

Disclosing predepression feelings of sadness is difficult for teens. Primary care providers are a potential avenue for teens to disclose these feelings and a bridge to mental health care before becoming more seriously ill. To explore how to more effectively recruit teens into a primary care-based, online depression prevention study, we held 5 focus groups with African American and Latino teens (n = 43) from a large Midwestern city. We conducted constant comparative analysis of the data and a theoretical conceptualization of coping and disclosure emerged. Our analysis revealed an internal coping continuum in reaction to sadness and pivotal elements of trust and judgment that either lead teens to disclose or not disclose these feelings. The teens’ perspectives show the necessary characteristics of a relationship and comfortable community and virtual settings that can best allow for teens to take the step of disclosing to receive mental health care services.

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