scholarly journals Lessons Learned From a Colocation Model Using Psychiatrists in Urban Primary Care Settings

2012 ◽  
Vol 4 (3) ◽  
pp. 228-234 ◽  
Author(s):  
Meredith Weiss ◽  
Bruce J. Schwartz
2002 ◽  
Vol 47 (9) ◽  
pp. 857-862 ◽  
Author(s):  
Nick Kates ◽  
Anne-Marie Crustolo ◽  
Sheryl Farrar ◽  
Lambrina Nikolaou

Objective: To describe a program that integrates mental health counsellors within primary care settings, to present data on the program's impact, and to discuss lessons learned that may apply in other communities. Methods: This paper describes a Canadian program that brings counsellors and psychiatrists into the offices of 87 family physicians in 36 practices in a community of 460 000 in Southern Ontario. It describes the goals and organization of the program and the activities of counsellors when working in primary care. In addition, it summarizes data from the program's evaluation, including demographic data and the individual problems seen and services delivered (all from the program's database) as well as data on patient outcomes using the General Health Questionnaire (GHQ), the Centre for Epidemiological Studies Depression (CESD) Rating Scale, and consumer-satisfaction questionnaires. Results: Each counsellor sees an average of 161 new cases yearly. The major problems are depression, anxiety, and family problems. In fact, over 70% of individuals who are seen show significant improvements in outcomes. The program has led to a significant increase in access to mental health services, a reduction in the use of traditional mental health services, high levels of satisfaction with counsellors and family physicians, and significant improvements in symptoms and functioning of individuals seen. Conclusion: This program has effectively integrated counsellors within primary care settings, increasing the capacity of primary care to handle mental health problems, strengthening links between providers from different sectors, and making mental health care more accessible.


Author(s):  
Margaret R. Emerson ◽  
Shinobu Watanabe-Galloway ◽  
Danae Dinkel ◽  
Suhasini Kotcherlakota ◽  
Louis Fok

2021 ◽  
pp. 152483992198927
Author(s):  
Erika L. Thompson ◽  
Kimberly G. Fulda ◽  
Jessica Grace ◽  
Annalynn M. Galvin ◽  
Emily E. Spence

Background Interpersonal violence (IPV) is a public health issue that disproportionately affects women. IPV screening improves likelihood of survivor disclosure and access to additional support. To enhance primary care IPV screening, Technology Enhanced Screening and Supportive Assistance (TESSA) uses integrated technological systems to deliver bidirectional, evidence-informed health navigation, health management, and safety interventions. This study evaluates TESSA implementation in primary care clinics using the Consolidated Framework for Implementation Research (CFIR). Method CFIR is a metatheoretical framework used for evaluating clinical intervention implementation. Salient constructs within CFIR’s five domains (intervention characteristics, outer setting, inner setting, characteristics of individuals, and process) were identified (23 constructs), and pertinent implementation details were examined. Results Key lessons learned included intervention characteristic constructs like intervention source (e.g., selecting tablets that can screen for items integral to the program’s aims) and adaptability (e.g., ensuring tablets worked with electronic medical records for each clinic), process constructs like engaging champions (e.g., garnering buy-in from key clinic stakeholders and staff), outer setting constructs like patient needs and resources (e.g., addressing pertinent patient resource needs) and external policies and incentives (e.g., incentivizing clinics by addressing clinic needs), and inner setting constructs like leadership engagement (e.g., ensuring buy-in from organizational leaders as leadership changed frequently). Conclusions CFIR identifies important implementation factors for programs like TESSA that screen for high-risk populations and implement in primary care settings. The TESSA program implementation permits increased IPV screening among primary health care populations, thus promoting access to resources for otherwise hard-to-reach populations.


2010 ◽  
Vol 28 (4) ◽  
pp. 356-368 ◽  
Author(s):  
Chad A. Graff ◽  
Paul Springer ◽  
George W. Bitar ◽  
Robert Gee ◽  
Rodolfo Arredondo

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