Canadian Approach to Integrated Care

2017 ◽  
Author(s):  
Nick Kates ◽  
Ellen Anderson
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Integrated Care ◽  
Healthcare Services ◽  
Lessons Learned ◽  
Mental Health Counselors ◽  
The Past ◽  
Collaborative Mental Health Care ◽  
Set Up ◽  
Mental Health Skills

This chapter describes the evolution of collaborative mental health care in Canada over the past 15 years, and the ways in which integrated care is becoming an increasingly integral part of Canada’s provincial and territorial healthcare services. It explores the underlying principles and models that can be found across the country. There is a particular emphasis on three things: (1) changes any mental health service can make to improve collaboration, (2) programs to increase the mental health skills and capacity of primary care, and (3) the integration of mental health services within primary care.A program in Hamilton, Ontario, has successfully integrated mental health counselors and psychiatrists into the offices of 170 family physicians across a city of 500,000 people for the past 20 years. The authors present data from the program’s evaluation, as well as key lessons learned and advice for other programs looking to set up similar models.

Why care about integrated care? Part 2. Integrated care systems: an irresistible force changing mental health services

2020 ◽  
pp. 1-12 ◽  
Author(s):  
Derek K. Tracy ◽  
Frank Holloway ◽  
Kara Hanson ◽  
Nikita Kanani ◽  
Matthew Trainer ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Mental Health Services ◽  
Health Services ◽  
Integrated Care ◽  
Healthcare Delivery ◽  
Local Implementation ◽  
The Past ◽  
Care Systems

SUMMARY Part 1 of this three-part series on integrated care discussed the drivers for change in healthcare delivery in England set out in the NHS Long Term Plan. This second part explores the evolution of mental health services within the wider National Health Service (NHS), and describes important relevant legislation and policy over the past decade, leading up to the 2019 Long Term Plan. We explain the implications of this, including the detail of emerging structures such as integrated care systems (ICSs) and primary care networks (PCNs), and conclude with challenges facing these novel systems. Part 3 will address the practical local implementation of integrated care.

Integrated Health Care: Improving Client Care while Providing Opportunities for Mental Health Counselors

2004 ◽  
Vol 26 (4) ◽  
pp. 321-331 ◽  
Author(s):  
Jana Bowling Aitken ◽  
Russ Curtis
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Health Care ◽  
Integrated Care ◽  
Integrated Health Care ◽  
Mental Health Counselors ◽  
Primary Care Settings ◽  
Client Care ◽  
Integrated Health ◽  
Receive Treatment

Integrated health care, the co-location of mental health and medical professionals within primary care settings, is an emerging trend. In essence, integrated care eases the access such that underserved primary care clients with mental health needs can receive treatment. Current models of integrated care are described, and strategies for mental health counselors' involvement within primary care settings are discussed.

scholarly journals Maudsley International: improving mental health and well-being around the world

2018 ◽  
Vol 15 (3) ◽  
pp. 49-51 ◽  
Author(s):  
Nick Bouras ◽  
Silvia Davey ◽  
Tracey Power ◽  
Jonathan Rolfe ◽  
Tom Craig ◽  
...  
Keyword(s):  
Mental Health ◽  
Social Care ◽  
Well Being ◽  
Building Capacity ◽  
The Past ◽  
Health And Social Care ◽  
The World ◽  
Set Up ◽  
Health And Well Being ◽  
And Training

Maudsley International was set up to help improve people's mental health and well-being around the world. A variety of programmes have been developed by Maudsley International over the past 10 years, for planning and implementing services; building capacity; and training and evaluation to support organisations and individuals, professionals and managers to train and develop health and social care provisions. Maudsley International's model is based on collaboration, sharing expertise and cultural understanding with international partners.

Lessons learned from the past on mental health care of refugee children in Serbia

2016 ◽  
Vol 25 (6) ◽  
pp. 669-672 ◽  
Author(s):  
Milica Pejovic Milovancevic ◽  
Veronika Ispanovic ◽  
Dusko Stupar
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Lessons Learned ◽  
Refugee Children ◽  
The Past

Integrating Clinical Nurse Specialists into the Treatment of Primary Care Patients with Depression

2003 ◽  
Vol 33 (1) ◽  
pp. 17-37 ◽  
Author(s):  
Ralph W. Swindle ◽  
Jaya K. Rao ◽  
Ahdy Helmy ◽  
Laurie Plue ◽  
X. H. Zhou ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Depressive Symptoms ◽  
Integrated Care ◽  
Medical Center ◽  
Treatment Plan ◽  
Intervention Group ◽  
Nurse Specialist ◽  
Clinical Nurse ◽  
Primary Care Patients

Objective: To examine the effectiveness of integrating generalist and specialist care for veterans with depression. Method: We conducted a randomized trial of patients screening positive for depression at two Veterans Affairs Medical Center general medicine clinic firms. Control firm physicians were notified prior to the encounter when eligible patients had PRIME-MD depression diagnoses. In the intervention firm, a mental health clinical nurse specialist (CNS) was to: design a treatment plan; implement that plan with the primary care physician; and monitor patients via telephone or visits at two weeks, one month and two months. Primary outcomes (depressive symptoms, patient satisfaction with health care) were collected at 3 and 12 months. Results: Of 268 randomized patients, 246 (92%) and 222 (83%) completed 3- and 12-month follow-up interviews. There were no between-group differences in depressive symptoms or satisfaction at 3 or 12 months. The intervention group had greater chart documentation of depression at baseline (63% versus 33%, p = 0.003) and a higher referral rate to mental health services at 3 months (27% versus 9%, p = 0.019). There was no difference in the rate of new prescriptions for, or adequate dosing of, anti-depressant medications. In 40% of patients, CNSs disagreed with the PRIME-MD depression diagnosis, and their rates of watchful waiting were correspondingly high. Conclusions: Implementing an integrated care model did not occur as intended. Experienced CNSs often did not see the need for treatment in many primary care patients identified by the PRIME-MD. Integrating integrated care models in actual practice may prove challenging.

scholarly journals Lessons learned from service design of a trial of a digital mental health service: Informing implementation in primary care clinics

2020 ◽  
Vol 10 (3) ◽  
pp. 598-605
Author(s):  
Andrea K Graham ◽  
Carolyn J Greene ◽  
Thomas Powell ◽  
Pauli Lieponis ◽  
Amanda Lunsford ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Mental Health Service ◽  
Health Service ◽  
Service Design ◽  
Lessons Learned ◽  
Primary Care Clinics ◽  
Digital Service ◽  
Direct To Consumer ◽  
Bridge Building

Abstract Implementing a digital mental health service in primary care requires integration into clinic workflow. However, without adequate attention to service design, including designing referral pathways to identify and engage patients, implementation will fail. This article reports results from our efforts designing referral pathways for a randomized clinical trial evaluating a digital service for depression and anxiety delivered through primary care clinics. We utilized three referral pathways: direct to consumer (e.g., digital and print media, registry emails), provider referral (i.e., electronic health record [EHR] order and provider recommendation), and other approaches (e.g., presentations, word of mouth). Over the 5-month enrollment, 313 individuals completed the screen and reported how they learned about the study. Penetration was 13%, and direct to consumer techniques, most commonly email, had the highest yield. Providers only referred 16 patients through the EHR, half of whom initiated the screen. There were no differences in referral pathway based on participants’ age, depression severity, or anxiety severity at screening. Ongoing discussions with providers revealed that the technologic implementation and workflow design may not have been optimal to fully affect the EHR-based referral process, which potentially limited patient access. Results highlight the importance of designing and evaluating referral pathways within service implementation, which is important for guiding the implementation of digital services into practice. Doing so can ensure that sustained implementation is not left to post-evaluation bridge-building. Future efforts should assess these and other referral pathways implemented in clinical practice outside of a research trial.

scholarly journals Cross Sector Data Sharing: Necessity, Challenge, and Hope

2019 ◽  
Vol 47 (S2) ◽  
pp. 83-86 ◽  
Author(s):  
Cason Schmit ◽  
Kathleen Kelly ◽  
Jennifer Bernstein
Keyword(s):  
Public Health ◽  
Mental Health ◽  
Law Enforcement ◽  
Data Sharing ◽  
Healthcare Services ◽  
Data Sources ◽  
Health Law ◽  
Set Up ◽  
Existing Data ◽  
Sector Data

Existing data sources have tremendous potential to inform public health activities. However, a patchwork of data protection laws impede data sharing efforts. Nevertheless, a data-sharing initiative in Peoria, IL was able to overcome challenges to set up a cross-sectoral data system to coordinate mental health, law enforcement, and healthcare services.

scholarly journals A Review Article on Internet-based Psychological Interventions in Primary Care. What is the Global Experience? How Reliable are Results from RCTs? Lessons Learned from the European, US and Australian Case Studies

2018 ◽  
Vol 8 (2) ◽  
pp. 145-163 ◽  
Author(s):  
Melita Sogomonjan ◽  
Tanel Kerikmäe ◽  
Pille Ööpik
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Cognitive Behavioural Therapy ◽  
Real Life ◽  
Mental Health Disorders ◽  
Behavioural Therapy ◽  
Lessons Learned ◽  
Cognitive Behavioural ◽  
Health Disorders ◽  
Use Of Internet

AbstractIn the context of the EU’s Digital Single Market (eHealth) Strategy, the deployment of digital tools for patients’ empowerment and person-centred care is of high demand and importance. Shifting from treatment to health promotion and disease prevention, a variety of internet-based cognitive behavioural therapy programmes have been proven to be effective for managing common mental health disorders in secondary care even hough the effectiveness and the clinical use of internet-based cognitive behavioural therapy programmes alone in primary care have not been approved yet. Additionally, such interventions are neither included in the international clinical guidelines for treating common mental health disorders nor regulated by Member States as a healthcare service. Despite that, the UK National Health Service and the Swedish National Board of Health and Welfare endorse the use of internet-based cognitive behavioural therapy as a first treatment option. The aim of this research is to investigate the global experience of internet-based cognitive behavioural therapy programmes in controlled and real-life conditions in general practice and to evaluate the reliability of the results and concomitantly their compliance with the European Commission’s eHealth Strategy. A systematic review of quantitative studies was conducted from January 2007 to December 2017. The results indicated that unsupported internet-based cognitive behavioural therapy programmes alone are less effective than combined therapy options for treatment purposes, if no additional therapy is prescribed. Guided internet-based cognitive behavioural therapy may supplement traditional treatment methods resulting in improving the control of mental disorders, but are unable to demonstrate consistent quality or replace face-to-face therapy.

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