scholarly journals Integration of Pediatric Behavioral Health Services in Primary Care: Improving Access and Outcomes with Collaborative Care

2018 ◽  
Vol 63 (7) ◽  
pp. 432-438 ◽  
Author(s):  
John V. Campo ◽  
Rose Geist ◽  
David J. Kolko

Objective: To examine collaborative care interventions to integrate pediatric mental health services into primary care as a means of addressing barriers to mental health service delivery, improving access to care, and improving health outcomes. Method: Selective review of published literature addressing structural and attitudinal barriers to behavioural health service delivery and the integration of behavioural health services for pediatric mental problems and disorders into primary care settings, with a special focus on Canadian and U.S. studies. Results: Integration of pediatric behavioural health services in primary care has potential to address structural and attitudinal barriers to care delivery, including shortages and the geographical misdistribution of behavioural health specialists. Integration challenges stigma by communicating that health cannot be compartmentalized into physical and mental components. Stepped collaborative care interventions have been demonstrated to be feasible and effective in improving access to behavioural health services, outcomes, and patient and family satisfaction relative to existing care models. Conclusion: Collaborative integration of behavioural health services into primary care is a promising means of improving access to care and outcomes for children and adolescents struggling with mental problems and disorders. Dissemination to real-world practice settings will likely require changes to existing models of reimbursement and the culture of health service delivery.

2007 ◽  
Vol 41 (10) ◽  
pp. 784-791 ◽  
Author(s):  
Timothy Wand ◽  
Kathryn White

The purpose of the present paper was to review the current models of mental health service delivery used in the emergency department (ED) setting. A search was conducted of the nursing and medical literature from 1990 to 2007 for relevant articles and reports. Consideration was also given to the global and local context influencing contemporary mental health services. Wider sociopolitical and socioeconomic influences and systemic changes in health-care delivery have dictated a considerable shift in attention for mental health services worldwide. The ED is a topical location that has attracted interest and necessitated a response. The mental health liaison nurse (MHLN) role embedded within the ED structure has demonstrated the most positive outcomes to date. This model aims to raise mental health awareness and address concerns over patient-focused outcomes such as reduced waiting times, therapeutic intervention and more efficient coordination of care and follow up for individuals presenting to the ED in psychological distress. Further research is required into all methods of mental health service delivery to the ED. The MHLN role is a cost-effective approach that has gained widespread approval from ED staff and mental health patients and is consistent with national and international expectations for mental health services to become fully integrated within general health care. The mental health nurse practitioner role situated within the ED represents a potentially promising alternative for enhanced public access to specialized mental health care.


2018 ◽  
Vol 7 (1) ◽  
pp. 57-71 ◽  
Author(s):  
Tahir Mahmood Ali ◽  
Sana Gul

Aim This study attempted to analyse the potential of two primary sources of mental health service delivery at a grassroots level, religious/faith healers and community/lady health workers, and how they can be effectively used to deliver mental health services in a resource-scarce country like Pakistan. Method A literature review was carried out for relevant studies conducted in Muslim countries between 2000 to 2015 reporting empirical results. Using the inclusion criteria, thirteen studies were selected for the review. Results The presented studies suggest that the main proportion of mental health patients in countries with major Muslim population including Pakistan, visit religious/faith healers first for treatment, however all studies are silent about the outcomes through these healers. The only potential visible outcome of contacting religious/faith healers is the identification of mental health cases. However, community/lady health workers with minimal training appeared to be a beneficial source of mental health service delivery in communities. Conclusion In a resource scarce country like Pakistan, networking with religious/faith healers can be established for effective identification and referral of mental health cases whereas strong and already existing community/lady health workers system can be used as a first level to deliver mental health service at the doorstep.


2020 ◽  
Vol 26 (3 Special Issue on COVID-19) ◽  
pp. 264-279
Author(s):  
Mehrdad Kazemzadeh Atoofi ◽  
◽  
Nazila Rezaei ◽  
Farzad Kompani ◽  
Fatemeh Shirzad ◽  
...  

Objectives: After the outbreak of a new viral disease in Wuhan, China, in late December 2019, COVID-19 in a very short time and rapidly became a global pandemic. Through a systematic review, the present paper investigated the requirements of Mental Health Services during the COVID-19 outbreak. Methods: A comprehensive search was conducted through PubMed and NLM Gateway (for MEDLINE), Institute of Scientific Information (ISI), and Scopus. PsychINFO and CINAHL data banks were also searched. The primary roots for the development of the search strategy developed based on the keywords of “Covid”, “mental health”, “care”, “services”. All relevant studies were included without any limitation of publication time or the papers’ language as it was not possible to conduct a formal systematic review given the nature of the publications. Instead, it was decided to conduct a mixed systematic and complementary narrative review covering different interested domains. Results: Out of 80 papers, after excluding duplications, 58 articles were selected for the refinement process. Three refining steps based on the titles, abstracts, and full texts led to data extraction from 4 eligible papers. Considering the importance of the problem, related findings, key points, and research findings were summarized and presented in terms of critical components of infrastructure and resources, including policy for at-risk groups, different approaches to mental health service delivery, indirect contexts for mental health service delivery, follow-up attitudes, and complementary research. The results of the study indicate that many studies considered the consequences of physical aspects and diagnostic symptoms. Thus, aspects of mental health have been either less focused or even neglected. In mental health consequences, immediate attention and intensive programs to assess mental health, preparation for support and treatment, and prevention services are emphasized. Conclusion: During the implementation of mental health interventions, to improve services and to consider the limitations and challenges of implementing programs, it is necessary to pay attention to the attitudes of target groups and their preference


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