The Integration of Care for Mental Health, Substance Abuse, and Other Behavioral Health Conditions Into Primary Care

2016 ◽  
Vol 164 (6) ◽  
pp. 447 ◽  
Author(s):  
Ryan A. Crowley ◽  
Neil Kirschner ◽  
Darilyn V. Moyer
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Substance Abuse ◽  
Behavioral Health ◽  
Health Conditions ◽  
Integration Of Care

Case Study—Addressing Behavioral Health with a Multisector Approach: Why We Started Community of Solutions

2019 ◽  
pp. 137-148
Author(s):  
Robert L. Phillips ◽  
Carol V. Davis ◽  
Ethan J. Phillips ◽  
Heather Davies ◽  
Valerie Flowe ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Substance Abuse ◽  
Behavioral Health ◽  
Negative Experiences ◽  
Primary Care Mental Health ◽  
Personal Story

This chapter shares a compelling and personal story of collaboration among primary care, mental health, schools, students, foundations, and government which aimed to reduce the risk of suicide in a given community. The chapter notes both positive and some negative experiences that the “community of solutions” faced in reducing substance abuse and building student resiliency.

scholarly journals A pilot comparison of medical records sensitivity perspectives of patients with behavioral health conditions and healthcare providers

2021 ◽  
Vol 27 (2) ◽  
pp. 146045822110099
Author(s):  
Hiral Soni ◽  
Julia Ivanova ◽  
Adela Grando ◽  
Anita Murcko ◽  
Darwyn Chern ◽  
...  
Keyword(s):  
Mental Health ◽  
Drug Abuse ◽  
Behavioral Health ◽  
Health Information ◽  
Healthcare Providers ◽  
Health Conditions ◽  
Mixed Methods Approach ◽  
Record Data ◽  
Category Labels

This pilot study compares medical record data sensitivity (e.g., depression is sensitive) and categorization perspective (e.g., depression categorized as mental health information) of patients with behavioral health conditions and healthcare providers using a mixed-methods approach employing patient’s own EHR. Perspectives of 25 English- and Spanish-speaking patients were compared with providers. Data categorization comparisons resulted in 66.3% agreements, 14.5% partial agreements, and 19.3% disagreements. Sensitivity comparisons obtained 54.5% agreement, 11.9% partial agreement, and 33.6% disagreements. Patients and providers disagreed in classification of genetic data, mental health, drug abuse, and physical health information. Factors influencing patients’ sensitivity determination were sensitive category comprehension, own experience, stigma towards category labels (e.g., drug abuse), and perception of information applicability (e.g., alcohol dependency). Knowledge of patients’ sensitivity perceptions and reconciliation with providers could expedite the development of granular and personalized consent technology.

scholarly journals Uncovering Prolonged Grief Reactions Subsequent to a Reproductive Loss: Implications for the Primary Care Provider

2021 ◽  
Vol 12 ◽  
Author(s):  
Kathryn R. Grauerholz ◽  
Shandeigh N. Berry ◽  
Rebecca M. Capuano ◽  
Jillian M. Early
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Pregnancy Loss ◽  
The United States ◽  
Time Span ◽  
Health Conditions ◽  
Relationship Problems ◽  
Mental Health Conditions ◽  
Reproductive Loss ◽  
Grief Reactions

IntroductionThere is a paucity of clinical guidelines for the routine assessment of maladaptive reproductive grief reactions in outpatient primary care and OB-GYN settings in the United States. Because of the disenfranchised nature of perinatal grief reactions, many clinicians may be apt to miss or dismiss a grief reaction that was not identified in the perinatal period. A significant number of those experiencing a reproductive loss exhibit signs of anxiety, depression, or post-traumatic stress disorder. Reproductive losses are typically screened for and recorded numerically as part of a woman’s well-visit intake, yet this process often fails to identify patients emotionally troubled by a prior pregnancy loss.Materials and MethodsA summative content analysis of 164 recent website blogs from female participants who self-reported having experienced a miscarriage or abortion in their lifetime was conducted. The narratives were reviewed for details regarding the time span between the pregnancy loss and the composition of the blog post. The stories were analyzed for subsequent relationship problems and detrimental mental health conditions. Maladaptive reactions were contrasted for those that indicated a greater than 12 months’ time-lapse and those who had not.ResultsMore than a third (39.6%) of the women reported in the narrative that at least one year or more had passed since experiencing the miscarriage or abortion. For those women, the median time span between the loss and composing the blog was 4 years with a range of 47 years. Mental health conditions attributed to the reproductive loss by those who reported longer bereavement times included subsequent relationship problems, substance misuse, depression, suicidal ideation, and PTSD. The percent of reported maladaptive issues was more than double (136.9% vs. 63.6%) for those who reported that a year or more had passed since the loss of the pregnancy.DiscussionGrief reactions following the loss of a pregnancy may be prolonged or delayed for several months which can contribute to adverse biopsychosocial outcomes. Recognition and treatment of maladaptive grief reactions following a pregnancy loss are critical. Screening methods should be enhanced for clinicians in medical office settings to help identify and expedite the appropriate mental health assistance.

On the same page or in a different book? A pilot project on the perceptions of educational needs in an era of shifting mental health care to primary care (Preprint)

2021 ◽  
Author(s):  
Stephanie Sutherland ◽  
Dahn Jeong ◽  
Michael Cheng ◽  
Mireille St-Jean ◽  
Alireza Jalali
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Health Care ◽  
Mental Health Care ◽  
Medical Management ◽  
Family Physicians ◽  
Educational Needs ◽  
Health Conditions ◽  
Care Providers ◽  
Mental Health Conditions

BACKGROUND There is an unmet need for mental health care in Canada. Seventy-five percent of visits for mental health services are related to mood and anxiety disorder, which occur most frequently in the primary care setting. Primary care providers such as general practitioners and family physicians are essential part of mental health care services. However, it is currently not well known what is needed to increase care providers’ willingness, comfort and skills to adequately provide care. OBJECTIVE The aim of this study was to understand the caregiver and family physician needs regarding the care and medical management of individuals with mental health conditions. METHODS A needs assessment was designed to understand the educational needs of caregivers and family physicians with regard to the provision of mental health care, specifically, to seek advice of the format and delivery mode for an educational curriculum to be accessed by both stakeholder groups. Exploratory qualitative interviews were conducted and data was collected and analysed iteratively until thematic saturation was achieved. RESULTS Caregivers of individuals with mental health conditions (n=24) and family physicians (n=10) were interviewed. Both caregivers and family physicians expressed dissatisfaction with the status quo regarding the provision of mental health care at the family physician’s office. They stated that there was a need for more educational materials as well as additional supports. Caregivers expressed a general lack of confidence in family physicians to manage their son/daughter’s mental health condition, while family physicians sought more networking opportunities to improve and facilitate provision of mental health care. CONCLUSIONS Robust qualitative studies are necessary to identify the educational and medical management needs of caregivers and family physicians. Understanding each other’s perspectives is an essential first step to collaboratively designing, implementing, and the subsequent evaluation of community-based mental health care. Fortunately, there are initiatives underway already to address these need areas (e.g. websites such as eMentalHealth.ca/PrimaryCare as well as mentorship and collaborative care network) and information from this study can help inform the gaps in those existing initiatives. CLINICALTRIAL NA

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