Benefits of a Primary Care Clinic Co-Located and Integrated in a Mental Health Setting for Veterans With Serious Mental Illness

Author(s):  
PA Pirraglia ◽  
E Rowland ◽  
W-C Wu ◽  
TH Taveira ◽  
LB Cohen ◽  
...  
2008 ◽  
Vol 27 (2) ◽  
pp. 129-138 ◽  
Author(s):  
Tamison Doey ◽  
Pamela Hines ◽  
Bonnie Myslik ◽  
JoAnn Elizabeth Leavey ◽  
Jamie A. Seabrook

Successful support of persons living with a mental illness in the community is challenged by the lack of primary care accessible to this population. The Canadian Mental Health Association–Windsor Essex County Branch explored options to provide mental and physical health care, initially creating an integrated primary care clinic and later a larger community health clinic co-located with its mental health care services and staffed by a multidisciplinary team. A retrospective review of 805 charts and a client satisfaction survey were conducted in 2001 to evaluate this service. Findings indicate that access to primary care and mental health care co-located at a community-based clinic has reduced the number of emergency room visits and admissions, and length of stay in hospital, for individuals with moderate to serious mental illness. A client survey in January 2008 supports these preliminary findings.


2010 ◽  
Vol 25 (S1) ◽  
pp. S49-S49
Author(s):  
N. Laor ◽  
A. Louden ◽  
S. Shachar ◽  
Z. Wiener

2015 ◽  
Vol 17 (05) ◽  
pp. 421-427 ◽  
Author(s):  
Alexandros Maragakis ◽  
Ragavan Siddharthan ◽  
Jill RachBeisel ◽  
Cassandra Snipes

Individuals with serious mental illness (SMI) are more likely to experience preventable medical health issues, such as diabetes, hyperlipidemia, obesity, and cardiovascular disease, than the general population. To further compound this issue, these individuals are less likely to seek preventative medical care. These factors result in higher usage of expensive emergency care, lower quality of care, and lower life expectancy. This manuscript presents literature that examines the health disparities this population experiences, and barriers to accessing primary care. Through the identification of these barriers, we recommend that the field of family medicine work in collaboration with the field of mental health to implement ‘reverse’ integrated care (RIC) systems, and provide primary care services in the mental health settings. By embedding primary care practitioners in mental health settings, where individuals with SMI are more likely to present for treatment, this population may receive treatment for somatic care by experts. This not only would improve the quality of care received by patients, but would also remove the burden of managing complex somatic care from providers trained in mental health. The rationale for this RIC system, as well as training and policy reforms, are discussed.


1996 ◽  
Vol 26 (4) ◽  
pp. 431-441 ◽  
Author(s):  
Mark Zimmerman ◽  
David T. Lush ◽  
Neil J. Farber ◽  
Jon Hartung ◽  
Gary Plescia ◽  
...  

Objective: The authors examined whether there is empirical support for the notion that medical patients are upset by being asked questions about psychiatric disorders. Method: Six hundred and one patients attending a primary care clinic completed the SCREENER—a newly developed, brief self-administered questionnaire that surveys a broad range of psychopathology. In addition, they completed a second questionnaire that assessed their attitudes toward the SCREENER. Results: We found a high level of acceptance by patients. The questions were judged easy to answer, and they rarely aroused significant negative affect. Fewer than 2 percent of the patients judged the questions difficult to answer, and fewer than 3 percent were “very much” embarrassed, upset, annoyed, or uncomfortable with the questions. Individuals with a history of psychiatric treatment and poorer current mental health reacted more unfavorably to the questionnaire. Conclusions: From the patient's perspective, it is feasible and acceptable to use self-administered questionnaires for routine screening of psychiatric problems in primary care settings.


Author(s):  
Luis H. Zayas ◽  
Nancy A. Busch-Rossnagel

By most accounts, pregnant Hispanic women are a population at risk for perinatal health and mental health problems. In this article, the authors report on a pilot study of the mental health status of 86 low-income, pregnant Hispanics. Three cases drawn from a community-based, primary care clinic demonstrate how Hispanic women may appear in the clinical setting and how interventions can be designed.


PEDIATRICS ◽  
1994 ◽  
Vol 93 (2) ◽  
pp. 289-295
Author(s):  
Lawrence S. Wissow ◽  
Modena E.H. Wilson ◽  
Debra L. Roter

Objective. Primary care pediatricians play an important role in the detection, diagnosis, treatment, and referral of children with mental health problems. Some parents, however, are reluctant to discuss behavioral and emotional symptoms with their child's pediatrician. Studies of patient-physician communication suggest that specific aspects of pediatrician interview style (asking questions about psychosocial issues, making supportive statements, and listening attentively) increase disclosure of sensitive information. We hypothesized that disclosures of parent and child psychosocial problems would be more likely to occur during visits when pediatricians used these techniques. Design. Cross-sectional analysis of a systematic sample of pediatric primary care visits. Population. Two hundred thirty-four children ages 6 months to 14 years and their mothers or female guardians attending an inner-city hospital-based pediatric primary care clinic; 52 physicians in their second or third year of pediatric residency training. Methods. Visits audiotaped and dialogue coded using the Roter Interactional Analysis System. Independent variables included counts of pediatrician utterances in the following categories: (a) questions about psychosocial issues, (b) statements of support and reassurance, and (c) statements indicating sympathetic and attentive listening. Dependent variables were the disclosure of information about: (a) parental medical or emotional impairment, (b) family disruption, (c) use of physical punishment, and (d) aggressive or overactive child behavior. Results. Use of psychosocially oriented interviewing techniques was associated with a greater likelihood of disclosure for all four of the topic areas studied. Odds ratios for disclosure, adjusted for parental concerns and child age, ranged from 1.09 to 1.22 depending on the interview technique and outcome involved. Positive associations were observed both for topics raised primarily in response to pediatrician questions (family and parent problems) and for topics raised primarily by mothers (behavior and punishment). Conclusions. Three simple communication skills were associated with disclosure of specific concerns relevant to child mental health. Training pediatricians to use these skills would help to better detect and diagnose children's mental health problems.


Diabetes Care ◽  
2014 ◽  
Vol 37 (8) ◽  
pp. 2261-2267 ◽  
Author(s):  
Judith A. Long ◽  
Andrew Wang ◽  
Elina L. Medvedeva ◽  
Susan V. Eisen ◽  
Adam J. Gordon ◽  
...  

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S389-S389
Author(s):  
Erin Kube ◽  
Grant Harris ◽  
Bret Hicken

Abstract As of 2012, more than half of Veterans receiving care within a VA medical facility were age 65 or older. They have complex co-occurring medical and mental health needs, cognitive impairments, functional deficits, and psychosocial complexity. In 2015, GeriPACT emerged as a specialized geriatric primary care clinic model to serve this vulnerable population. The presence of psychologists in geriatrics has significant implications for treatment of cognitive, behavioral, and psychosocial needs. This mixed methods project aimed to describe the current scope and functions of GeriPACT psychologists and differentiate their services from other PACT clinics. Twenty total GeriPACT psychologists participated. The results suggest that mental health services within GeriPACT are multifaceted and need-driven. Significant themes highlight role specific characteristics of psychologists, clinician backgrounds, team education, and referral processes to improve access to care. Recommendations for implementation, clinician training, and future policy planning will also be presented.


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