scholarly journals The effectiveness of an integrated collaborative care model vs. a shifted outpatient collaborative care model on community functioning, residential stability, and health service use among homeless adults with mental illness: a quasi-experimental study

2015 ◽  
Vol 15 (1) ◽  
Author(s):  
Vicky Stergiopoulos ◽  
Andrée Schuler ◽  
Rosane Nisenbaum ◽  
Wayne deRuiter ◽  
Tim Guimond ◽  
...  
Keyword(s):  
Experimental Study ◽  
Mental Illness ◽  
Collaborative Care ◽  
Service Use ◽  
Health Service Use ◽  
Care Model ◽  
Homeless Adults ◽  
Community Functioning ◽  
Collaborative Care Model ◽  
Quasi Experimental

scholarly journals SMI Life Goals: Description of a randomized trial of a Collaborative Care Model to improve outcomes for persons with serious mental illness

2014 ◽  
Vol 39 (1) ◽  
pp. 74-85 ◽  
Author(s):  
Amy M. Kilbourne ◽  
Margretta Bramlet ◽  
Michelle M. Barbaresso ◽  
Kristina M. Nord ◽  
David E. Goodrich ◽  
...  
Keyword(s):  
Mental Illness ◽  
Randomized Trial ◽  
Serious Mental Illness ◽  
Collaborative Care ◽  
Life Goals ◽  
Care Model ◽  
Collaborative Care Model

scholarly journals Collaborative care model for depression in rural Nepal: a mixed-methods implementation research study

BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e048481
Author(s):  
Pragya Rimal ◽  
Nandini Choudhury ◽  
Pawan Agrawal ◽  
Madhur Basnet ◽  
Bhavendra Bohara ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Mixed Methods ◽  
Implementation Research ◽  
Collaborative Care ◽  
Mental Healthcare ◽  
Clinical Impact ◽  
Care Model ◽  
Collaborative Care Model ◽  
Rural Nepal

IntroductionDespite carrying a disproportionately high burden of depression, patients in low-income countries lack access to effective care. The collaborative care model (CoCM) has robust evidence for clinical effectiveness in improving mental health outcomes. However, evidence from real-world implementation of CoCM is necessary to inform its expansion in low-resource settings.MethodsWe conducted a 2-year mixed-methods study to assess the implementation and clinical impact of CoCM using the WHO Mental Health Gap Action Programme protocols in a primary care clinic in rural Nepal. We used the Capability Opportunity Motivation-Behaviour (COM-B) implementation research framework to adapt and study the intervention. To assess implementation factors, we qualitatively studied the impact on providers’ behaviour to screen, diagnose and treat mental illness. To assess clinical impact, we followed a cohort of 201 patients with moderate to severe depression and determined the proportion of patients who had a substantial clinical response (defined as ≥50% decrease from baseline scores of Patient Health Questionnaire (PHQ) to measure depression) by the end of the study period.ResultsProviders experienced improved capability (enhanced self-efficacy and knowledge), greater opportunity (via access to counsellors, psychiatrist, medications and diagnostic tests) and increased motivation (developing positive attitudes towards people with mental illness and seeing patients improve) to provide mental healthcare. We observed substantial clinical response in 99 (49%; 95% CI: 42% to 56%) of the 201 cohort patients, with a median seven point (Q1:−9, Q3:−2) decrease in PHQ-9 scores (p<0.0001).ConclusionUsing the COM-B framework, we successfully adapted and implemented CoCM in rural Nepal, and found that it enhanced providers’ positive perceptions of and engagement in delivering mental healthcare. We observed clinical improvement of depression comparable to controlled trials in high-resource settings. We recommend using implementation research to adapt and evaluate CoCM in other resource-constrained settings to help expand access to high-quality mental healthcare.

History of Forensic Mental Health Service Use Among Homeless Adults with Mental Illness

2017 ◽  
Vol 16 (1) ◽  
pp. 69-82 ◽  
Author(s):  
Alicia Nijdam-Jones ◽  
Tonia L. Nicholls ◽  
Anne G. Crocker ◽  
Laurence Roy ◽  
Julian M. Somers
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Mental Health Service ◽  
Health Service ◽  
Service Use ◽  
Mental Health Service Use ◽  
Health Service Use ◽  
Forensic Mental Health ◽  
Homeless Adults ◽  
History Of

scholarly journals Racial-Ethnic Differences in Health Service Use in a Large Sample of Homeless Adults With Mental Illness From Five Canadian Cities

2016 ◽  
Vol 67 (9) ◽  
pp. 1004-1011 ◽  
Author(s):  
Vicky Stergiopoulos ◽  
Agnes Gozdzik ◽  
Rosane Nisenbaum ◽  
Helen-Maria Vasiliadis ◽  
Catharine Chambers ◽  
...  
Keyword(s):  
Mental Illness ◽  
Health Service ◽  
Ethnic Differences ◽  
Service Use ◽  
Health Service Use ◽  
Homeless Adults ◽  
Large Sample ◽  
Racial Ethnic ◽  
Adults With Mental Illness

scholarly journals Factors associated with higher healthcare costs in a cohort of homeless adults with a mental illness and a general cohort of adults with a history of homelessness

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kathryn Wiens ◽  
Laura C. Rosella ◽  
Paul Kurdyak ◽  
Simon Chen ◽  
Tim Aubry ◽  
...  
Keyword(s):  
Mental Illness ◽  
Healthcare Costs ◽  
Service Use ◽  
Multinomial Logistic Regression ◽  
Service Planning ◽  
Inpatient Service ◽  
Homeless Adults ◽  
Targeted Interventions ◽  
Factors Associated ◽  
History Of

Abstract Background Healthcare costs are disproportionately incurred by a relatively small group of people often described as high-cost users. Understanding the factors associated with high-cost use of health services among people experiencing homelessness could help guide service planning. Methods Survey data from a general cohort of adults with a history of homelessness and a cohort of homeless adults with mental illness were linked with administrative healthcare records in Ontario, Canada. Total costs were calculated using a validated costing algorithm and categorized based on population cut points for the top 5%, top 6–10%, top 11–50% and bottom 50% of users in Ontario. Multinomial logistic regression was used to identify the predisposing, enabling, and need factors associated with higher healthcare costs (with bottom 50% as the reference). Results Sixteen percent of the general homeless cohort and 30% percent of the cohort with a mental illness were in the top 5% of healthcare users in Ontario. Most healthcare costs for the top 5% of users were attributed to emergency department and inpatient service costs, while the costs from other strata were mostly for physician services, hospital outpatient clinics, and medications. The odds of being within the top 5% of users were higher for people who reported female gender, a regular medical doctor, past year acute service use, poor perceived general health and two or more diagnosed chronic conditions, and were lower for Black participants and other racialized groups. Older age was not consistently associated with higher cost use; the odds of being in the top 5% were highest for 35-to-49-year year age group in the cohort with a mental illness and similar for the 35–49 and ≥ 50-year age groups in the general homeless cohort. Conclusions This study combines survey and administrative data from two cohorts of homeless adults to describe the distribution of healthcare costs and identify factors associated with higher cost use. These findings can inform the development of targeted interventions to improve healthcare delivery and support for people experiencing homelessness.

A Pharmacist-Led Collaborative Care Model for Cardiometabolic Risk Reduction: A Case Study

2021 ◽  
pp. 2633559X2199485
Author(s):  
Shawn R. Smith ◽  
Christian W. Ruiz ◽  
Salihah Ali ◽  
Caroline J. Kim ◽  
Michael S. Murchie ◽  
...  
Keyword(s):  
Risk Reduction ◽  
Collaborative Care ◽  
Cardiometabolic Risk ◽  
Care Model ◽  
Collaborative Care Model
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