Improving access to evidencebased mental health care: general practitioners and allied health professionals collaborate

2004 ◽  
Vol 9 (4) ◽  
pp. 125-130 ◽  
Author(s):  
Jane Pirkis ◽  
Belinda Morley ◽  
Fay Kohn ◽  
Grant Blashkl ◽  
Philip Burgess ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
General Practitioners ◽  
Health Professionals ◽  
Allied Health ◽  
Allied Health Professionals

scholarly journals Models of psychological service provision under Australia's Better Outcomes in Mental Health Care program

2006 ◽  
Vol 30 (3) ◽  
pp. 277 ◽  
Author(s):  
Jane Pirkis ◽  
Philip Burgess ◽  
Fay Kohn ◽  
Belinda Morley ◽  
Grant Blashki ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Health Professionals ◽  
Allied Health ◽  
Care Program ◽  
Local Context ◽  
Allied Health Professionals ◽  
Psychological Service ◽  
Health Care Program

The Access to Allied Psychological Services component of Australia?s Better Outcomes in Mental Health Care program enables eligible general practitioners to refer consumers to allied health professionals for affordable, evidence-based mental health care, via 108 projects conducted by Divisions of General Practice. The current study profiled the models of service delivery across these projects, and examined whether particular models were associated with differential levels of access to services. We found: � 76% of projects were retaining their allied health professionals under contract, 28% via direct employment, and 7% some other way; � Allied health professionals were providing services from GPs? rooms in 63% of projects, from their own rooms in 63%, from a third location in 42%; and � The referral mechanism of choice was direct referral in 51% of projects, a voucher system in 27%, a brokerage system in 24%, and a register system in 25%. Many of these models were being used in combination. No model was predictive of differential levels of access, suggesting that the approach of adapting models to the local context is proving successful.

Australian primary mental health care: improving access and outcomes

2009 ◽  
Vol 15 (3) ◽  
pp. 244 ◽  
Author(s):  
Justine R. Fletcher ◽  
Jane E. Pirkis ◽  
Bridget Bassilios ◽  
Fay Kohn ◽  
Grant A. Blashki ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
General Practitioners ◽  
Care Program ◽  
Behavioural Therapy ◽  
Good Evidence ◽  
Allied Health Professionals ◽  
Health Service Provision ◽  
Over Time

The progressive achievements over time of the Access to Allied Psychological Services (ATAPS) component of the Better Outcomes in Mental Health Care program are examined using a web-based, purpose-designed minimum dataset that collects provider-, consumer- and session-level data on the projects. Findings indicate that the ATAPS projects have established themselves over time as a cornerstone of mental health service provision in Australia. Despite the more recent introduction of the complementary Better Access to Psychiatrists, Psychologists and General Practitioners through the Medicare Benefits Schedule program, the ATAPS projects have continued, since 2001, to attract substantial numbers of general practitioners and allied health professionals and deliver services to significant numbers of consumers. The profile of consumers being referred to the projects is now very consistent, with the majority being women with high prevalence disorders who may have had difficulty accessing mental health care in the past. The nature of sessions being delivered through the projects has also reached a point of consistency, with the majority being individual-level, cognitive behavioural therapy-based sessions of around 1 h in length. The only variation in session delivery is related to the charging of a co-payment. There is good evidence that the projects are achieving positive outcomes for consumers.

Better Outcomes in Mental Health Care: Impact of Different Models of Psychological Service Provision on Patient Outcomes

2007 ◽  
Vol 41 (2) ◽  
pp. 142-149 ◽  
Author(s):  
Belinda Morley ◽  
Jane Pirkis ◽  
Kristy Sanderson ◽  
Philip Burgess ◽  
Fay Kohn ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Service Delivery ◽  
Patient Outcomes ◽  
Health Professionals ◽  
Allied Health ◽  
Psychological Services ◽  
Allied Health Professionals ◽  
Models Of Service Delivery ◽  
Direct Referral

Objective: One hundred and eight Access to Allied Psychological Services projects have been funded under Australia's Better Outcomes in Mental Health Care programme since July 2001. All projects are run by Divisions of General Practice and enable general practitioners (GPs) to refer patients to allied health professionals for evidence-based care. They differ in the models they use to retain, locate and direct referrals to their allied health professionals. This paper examines the extent to which the projects are achieving positive patient outcomes, and explores the association between different models of service delivery and varying levels of patient outcomes. Method: The paper draws on two data sources (a purpose-designed minimum dataset and a survey of models of service delivery) to examine the level of patient outcomes within and across projects, and variations in the level of patient outcomes by models of service delivery. Results: The projects are achieving positive effects and these are mostly of large or medium magnitude. The projects do not differ markedly in terms of the patient outcomes they are achieving, despite differences in the models of service delivery they are using. However, those projects implementing a direct referral model, where the GP refers the patient directly to the allied health professional, have significantly greater effect sizes, indicating that they are achieving greater improvements in patient outcomes. In addition, there are non-significant trends toward direct employment of allied health professionals by Divisions being predictive of greater improvements in patient outcomes, and delivery of services from allied health professionals’ own rooms being predictive of weaker patient outcomes. Conclusions: Overwhelmingly, the Access to Allied Psychological Services projects are having a positive impact for patients in terms of their level of functioning, severity of symptoms and/or quality of life. Preliminary indications suggest that a service delivery model incorporating the use of a direct referral system may be associated with superior outcomes. The findings are discussed in the light of the imminent listing of psychologists’ services on the Medicare Benefits Schedule.

scholarly journals Intent to Adopt Video-Based Integrated Mental Health Care and the Characteristics of its Supporters: Mixed Methods Study Among General Practitioners Applying Diffusion of Innovations Theory

10.2196/23660 ◽  
2020 ◽  
Vol 7 (10) ◽  
pp. e23660
Author(s):  
Markus W Haun ◽  
Isabella Stephan ◽  
Michel Wensing ◽  
Mechthild Hartmann ◽  
Mariell Hoffmann ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
General Practitioners ◽  
Diffusion Of Innovations ◽  
Significant Proportion ◽  
The United States ◽  
Diffusion Of Innovations Theory ◽  
Early Adopters ◽  
Adopter Categories

Background Most people with common mental disorders, including those with severe mental illness, are treated in general practice. Video-based integrated care models featuring mental health specialist video consultations (MHSVC) facilitate the involvement of specialist mental health care. However, the potential uptake by general practitioners (GPs) is unclear. Objective This mixed method preimplementation study aims to assess GPs’ intent to adopt MHSVC in their practice, identify predictors for early intent to adopt (quantitative strand), and characterize GPs with early intent to adopt based on the Diffusion of Innovations Theory (DOI) theory (qualitative strand). Methods Applying a convergent parallel design, we conducted a survey of 177 GPs and followed it up with focus groups and individual interviews for a sample of 5 early adopters and 1 nonadopter. We identified predictors for intent to adopt through a cumulative logit model for ordinal multicategory responses for data with a proportional odds structure. A total of 2 coders independently analyzed the qualitative data, deriving common characteristics across the 5 early adopters. We interpreted the qualitative findings accounting for the generalized adopter categories of DOI. Results This study found that about one in two GPs (87/176, 49.4%) assumed that patients would benefit from an MHSVC service model, about one in three GPs (62/176, 35.2%) intended to adopt such a model, the availability of a designated room was the only significant predictor of intent to adopt in GPs (β=2.03, SE 0.345, P<.001), supporting GPs expected to save time and took a solution-focused perspective on the practical implementation of MHSVC, and characteristics of supporting and nonsupporting GPs in the context of MHSVC corresponded well with the generalized adopter categories conceptualized in the DOI. Conclusions A significant proportion of GPs may function as early adopters and key stakeholders to facilitate the spread of MHSVC. Indeed, our findings correspond well with increasing utilization rates of telehealth in primary care and specialist health care services (eg, mental health facilities and community-based, federally qualified health centers in the United States). Future work should focus on specific measures to foster the intention to adopt among hesitant GPs.

scholarly journals Health professionals' views of services for schizophrenia – fragmentation and inequality

2000 ◽  
Vol 24 (2) ◽  
pp. 47-50 ◽  
Author(s):  
Peter Haddad ◽  
Martin Knapp
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Great Britain ◽  
Mental Health Care ◽  
Inner City ◽  
Health Professionals ◽  
Psychiatric Nurses ◽  
Mental Health Care System ◽  
Educational Grant ◽  
Community Psychiatric

There has been much debate about effective treatments, service configurations and costs within Britain's mental health care system, but it has largely taken place in academic and management circles. We were interested in the views of those providing care. We organised a meeting of community psychiatric nurses, general practitioners and consultant psychiatrists (funded with an educational grant from Zeneca Pharmaceuticals). Participants worked in various parts of Great Britain, including rural and inner city areas. The authors facilitated the discussion, the emphasis of which was on participants' clinical experience.

scholarly journals Mental health in primary health care: professionals’ perceptions and patients’ levels of depression, anxiety and stress

2020 ◽  
Vol 3 (1) ◽  
Author(s):  
Tatiana Varela Madureira ◽  
Maria Cristina Quintas Antunes
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Primary Health Care ◽  
Health Services ◽  
Mental Health Care ◽  
Health Professionals ◽  
Mental Health Problems ◽  
Anxiety And Depression ◽  
Self Administration ◽  
Primary Health

Background: The integration of mental health in primary health care, throughout its various functional units and with effective articulation between primary health care and mental health services, has been considered an essential objective of the legislative documents produced in the last three decades in Portugal, among them the National Health Plan 2011-2016.Goals: This study aimed to inquire health professionals’ perceptions about mental health care provided by public primary health care units, namely their perceptions about the mental health of their patients. It also intended to explore the difficulties perceived by the health professionals in their daily activity about the mental health problems of their patients and about the need of clinical psychologists’ activity in the public primary health care.Methods: This is an observational cross-sectional study with two non-probabilistic samples: health professionals (doctors, nurses and psychologists) and patients from two public health care units. Health professionals were interviewed (individual structured face-to-face interviews) about their perceptions of needs for improving their capacity to provide mental healthcare and about patients’ mental health conditions. Patients responded (by self-administration) to the Depression, Anxiety and Stress Scale (DASS-21), providing a characterization of patients’ stress, anxiety and symptoms of depression.Results: Health professionals in their daily practice often identify in their patients symptoms of stress, anxiety and depression (most particularly in adults),. Several issues were identified as problematic, such as: poor access of the referral system for psychiatric and clinical psychological specialized care, insufficient number of health professionals, particularly of psychologists, and lack of appropriate mental health care specialization. The results also revealed relevant levels of stress, anxiety and depression in primary health care patients (both genders), which seem to increase with age. Discussion: Difficulties identified by health professionals may relate to the centralisation of resources, resistance to change from human resources management, lack of consensus among the various decision groups linked to mental health and, at institutional level, insufficient and inadequate funding. These factors may contribute to a failure in early diagnosis of symptoms of depression, anxiety and stress. It is expected that articulation between primary health services and differentiated health services will improve, with improvement in teamwork among professionals and increase of the quality of life of users, satisfaction with work, from health professionals,  and reduction of health costs.

Responding and adapting to change: an allied health perspective

2020 ◽  
Vol 33 (4) ◽  
pp. 339-349
Author(s):  
Lisa Beasley ◽  
Sandra Grace ◽  
Louise Horstmanshof
Keyword(s):  
Health Care ◽  
Change Management ◽  
Scoping Review ◽  
Health Professionals ◽  
Allied Health ◽  
Change Processes ◽  
Allied Health Professionals ◽  
Content Type ◽  
Scoping Reviews ◽  
Change Leaders

Purpose The purpose of this paper is to review the literature on the response and adaption to change of allied health professionals. Understanding how individuals respond and adapt to change is essential to assist leaders to manage transformational change effectively. Contemporary health-care environments are characterised by frequent and rapid change, often with unrealistic and challenging time frames. Individuals operate independently, but also as members of teams, professions and organisations. Therefore, having a sound understanding of individual response to change is important for change leaders. In the Australian context, allied health professionals represent a quarter of the health-care workforce. There is a significant gap in understanding how allied health professionals respond and adapt to change. Design/methodology/approach A scoping review was designed to report on the nature and extent of the literature on the response and adaption to change in the context of allied health professionals. Change leaders in the health-care environment face a number of complex challenges when attempting to facilitate change. While this scoping review did not identify any specific literature on the response and adaption to change of allied health professionals, it did however provide information on change models and factors to take into consideration when implementing a change process. Findings The results of this scoping review identified findings in two main areas with regard to response and adaptation of allied health to change: a review of change management literature at the organisation level and change management for allied health. Most of the literature described organisational level change management without providing a structural framework for change. At the professional individual level, the literature focused on specific clinical interventions, rather than on the response and adaption to change for allied health. Minimal literature was identified in regard to the response and adaption to change of allied health professionals. In an environment characterised by continuous change and policy reform, a greater understanding of the response and adaption to change by allied health is a priority for research, policy and practice. Research limitations/implications This scoping review was undertaken to explore the response and adaption to change of allied health. It sought to identify the factors that may explain why certain disciplines within the allied health professional group responded to change differently. Scoping reviews do not set out to comprehensively source all relevant literature but rather to ascertain the nature and extent of the published literature in the field. Therefore, it is possible that a systematic review might uncover additional relevant papers. However, this scoping review provides a clear indication of the nature and extent of the literature in allied health. Practical implications Social implications This scoping review will assist change leaders to gain a better understanding of theoretical frameworks of individual, team and organisational change processes and the impacts these have individually and collectively on change processes. Originality/value To the best of the authors’ knowledge, this scoping review is the first of its kind to identify the minimal literature available on the way allied health professionals respond and adapt to change.

Mental health services for individuals at risk of suicide in Peru: Attitudes and perspectives of mental health professionals

2020 ◽  
pp. 002076402094678
Author(s):  
Dana Alonzo ◽  
Dafne Aida Zapata Pratto
Keyword(s):  
Mental Health ◽  
Health Care ◽  
At Risk ◽  
Mental Health Care ◽  
Health Care System ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Specialized Training ◽  
Mental Health Care System ◽  
Care System

Background: Mental Health professionals often have to deal with at-risk individuals in crises and lack specialized training on suicide risk assessment and intervention. This study examined mental health professionals’ attitudes toward at-risk individuals and their perceptions of the quality of training and treatment available for assessing and intervening with this population. Methods: A total of 32 mental health professionals (13 psychiatrists, 16 psychologists, 2 psychiatric nurses; 1 social assistant) from highly vulnerable communities in Lima, Peru discussed their perceptions in four focus groups conducted by the authors. Results: Participants reported glaring deficiencies in all areas explored including training, knowledge and skills regarding suicide assessment and management. In addition, using ground theory analysis, three domains of findings emerged representing barriers and facilitators of treatment engagement, risk and protective factors of suicide and pros and cons of the current mental health care system including micro-, mezzo- and macro-level factors. The most frequently identified barrier was the perception that suicide is illegal; facilitator was family involvement; risk factor was poor parenting; protective factor was religious beliefs; pro of mental health care system was establishment of community-based services and con of mental health care system was lack of access to psychiatrists. Conclusion: The lack of specialized training available in the institutions that are designed to prepare mental health professionals for working with at-risk individuals is notable and has a direct and known impact self-identified by helping professionals. The need and desire for targeted training is palpable and essential to address growing rates of suicide, particularly among youth, in Peru.

Sign in / Sign up

Export Citation Format

Share Document