scholarly journals Mental Health and Primary Care: Contributing to Mental Health System Transformation in Canada

2017 ◽  
Vol 36 (4) ◽  
pp. 33-67 ◽  
Author(s):  
Nick Kates
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Health Care ◽  
Health Care Systems ◽  
Primary Care Providers ◽  
Health Providers ◽  
Care Providers ◽  
System Transformation ◽  
Mental Health Systems ◽  
Care Systems

For 20 years mental health and primary care providers across Canada have been working collaboratively together to improve access to care, provider skills, and patient experience. The new strategic plan of the Mental Health Commission of Canada (MHCC) offers many opportunities for collaborative care to play a role in the transformation of Canada’s mental health systems. To assist the plan, this paper presents principles underlying successful projects and ways that mental health and primary care services can work together more collaboratively, including integrating mental health providers in primary care. It integrates these concepts into a Canadian Model for Collaborative Mental Health Care that can guide future expansion of these approaches, and suggests ways in which better collaboration can address wider issues facing all of Canada’s health care systems.

Satisfaction with Primary Health Care and Confidence in General Practitioners: An Exploratory Comparison of US and UK Students

1993 ◽  
Vol 6 (2) ◽  
pp. 89-98
Author(s):  
Bodo B. Schlegelmilch ◽  
James M. Carman
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Health Care Systems ◽  
Primary Care Providers ◽  
Care Providers ◽  
Primary Health ◽  
The Us ◽  
Care Systems ◽  
The Uk ◽  
Oriented System

This paper explores attitudes of university students towards two differently organised health services, ie the National Health Service in the UK and the more market oriented system in the US and analyses the level of confidence placed in primary care providers (GPs/family physicians) in both systems. Although major differences in the perception of the two health care systems are identified, hardly any differences emerge between the two countries in terms of the confidence patients place in their primary care providers.

scholarly journals Seeking Care for Hyperglycemia in the Emergency Department: Through the Eyes of the Patient

2020 ◽  
Author(s):  
Justin W. Yan ◽  
Dimah Azzam ◽  
Melanie P. Columbus ◽  
Kristine Van Aarsen ◽  
Selina L. Liu ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Emergency Department ◽  
Hospital Admission ◽  
Health Care Systems ◽  
Primary Care Providers ◽  
Urgent Care ◽  
Care Providers ◽  
Health Care Settings ◽  
Care Systems

Health care systems often provide a range of options of care for patients with illnesses who do not require hospital admission. For individuals with diabetes, these options may include primary care providers, specialized diabetes clinics, and urgent care and walk-in clinics. We explored the reasons why patients choose the Emergency Department over other health care settings when seeking care for hyperglycemia.

scholarly journals Inter-clinician eConsults without programmatic incentives or requirements: a qualitative study of primary care provider perspectives

2020 ◽  
Vol 37 (4) ◽  
pp. 525-529 ◽  
Author(s):  
Leah Zallman ◽  
Carolyn F Fisher ◽  
Sofia Ladner ◽  
Kira Mengistu ◽  
Alison B Rapaport ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Focus Groups ◽  
Health Care Systems ◽  
Primary Care Providers ◽  
Safety Net ◽  
Care Providers ◽  
Provider Perspectives ◽  
Care Systems ◽  
The Usa

Abstract Background Inter-clinician electronic consultation (eConsult) programmes are becoming more widespread in the USA as health care systems seek innovative ways of improving specialty access. Existing studies examine models with programmatic incentives or requirements for primary care providers (PCPs) to participate. Objective We aimed to examine PCP perspectives on eConsults in a system with no programmatic incentive or requirement for PCPs to use eConsults. Methods We conducted seven focus groups with 41 PCPs at a safety-net community teaching health care system in Eastern Massachusetts, USA. Results Focus groups revealed that eConsults improved PCP experience by enabling patient-centred care and enhanced PCP education. However, increased workload and variations in communication patterns added challenges for PCPs. Patients were perceived as receiving timelier and more convenient care. Timelier care combined with direct documentation in the patient record was perceived as improving patient safety. Although cost implications were less clear, PCPs perceived costs as being lowered through fewer unnecessary visits and laboratories. Conclusions Our findings suggest that eConsult systems with no programmatic incentives or requirements for PCPs have the potential to improve care.

scholarly journals Seeking Care for Hyperglycemia in the Emergency Department: Through the Eyes of the Patient

2020 ◽  
Author(s):  
Justin W. Yan ◽  
Dimah Azzam ◽  
Melanie P. Columbus ◽  
Kristine Van Aarsen ◽  
Selina L. Liu ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Emergency Department ◽  
Hospital Admission ◽  
Health Care Systems ◽  
Primary Care Providers ◽  
Urgent Care ◽  
Care Providers ◽  
Health Care Settings ◽  
Care Systems

Health care systems often provide a range of options of care for patients with illnesses who do not require hospital admission. For individuals with diabetes, these options may include primary care providers, specialized diabetes clinics, and urgent care and walk-in clinics. We explored the reasons why patients choose the Emergency Department over other health care settings when seeking care for hyperglycemia.

scholarly journals Quantification of the resilience of primary care networks by stress testing the health care system

2019 ◽  
Vol 116 (48) ◽  
pp. 23930-23935 ◽  
Author(s):  
Donald Ruggiero Lo Sardo ◽  
Stefan Thurner ◽  
Johannes Sorger ◽  
Georg Duftschmid ◽  
Gottfried Endel ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Health Care System ◽  
Large Scale ◽  
Health Care Systems ◽  
Primary Care Providers ◽  
Care Providers ◽  
Physician Density ◽  
Care Systems ◽  
Care System

There are practically no quantitative tools for understanding how much stress a health care system can absorb before it loses its ability to provide care. We propose to measure the resilience of health care systems with respect to changes in the density of primary care providers. We develop a computational model on a 1-to-1 scale for a countrywide primary care sector based on patient-sharing networks. Nodes represent all primary care providers in a country; links indicate patient flows between them. The removal of providers could cause a cascade of patient displacements, as patients have to find alternative providers. The model is calibrated with nationwide data from Austria that includes almost all primary care contacts over 2 y. We assign 2 properties to every provider: the “CareRank” measures the average number of displacements caused by a provider’s removal (systemic risk) as well as the fraction of patients a provider can absorb when others default (systemic benefit). Below a critical number of providers, large-scale cascades of patient displacements occur, and no more providers can be found in a given region. We quantify regional resilience as the maximum fraction of providers that can be removed before cascading events prevent coverage for all patients within a district. We find considerable regional heterogeneity in the critical transition point from resilient to nonresilient behavior. We demonstrate that health care resilience cannot be quantified by physician density alone but must take into account how networked systems respond and restructure in response to shocks. The approach can identify systemically relevant providers.

Transgender People's Perceptions of Medical Treatment: Implications for Providers and Loved Ones

2021 ◽  
pp. 106648072110523
Author(s):  
Nikolai Guimaoutdinov ◽  
Jane M. Tram
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Health Care Providers ◽  
Qualitative Data ◽  
Health Care Systems ◽  
Mental Health Providers ◽  
Health Providers ◽  
Care Providers ◽  
Health Care Barriers ◽  
Care Systems

In this study, we examine qualitative data from 73 transgender adults. We present the information our participants shared about their experiences navigating health care systems (i.e., medical health, mental health, other providers). Four themes emerged. First, participants indicated that they wanted health care providers to be more aware of transgender-specific terminology, identities, and experiences. Second, participants were concerned that health care providers blame their medical transition for unrelated health concerns. Third, participants said they did not want health care providers to probe transgender patients about their transitions. Fourth, they reported that they wanted health care providers to treat transgender patients as individuals rather than a monolith. Our research has implications for mental health providers because they benefit from understanding the health care barriers experienced by their transgender patients, in mental health and other health realms. This will allow mental health providers to better support their patients as well as bolster support from loved ones.

754 Insomnia and Depression Symptoms in Primary Care Patients Referred for Mental Health Care

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A294-A294
Author(s):  
Ivan Vargas ◽  
Alexandria Muench ◽  
Mark Seewald ◽  
Cecilia Livesey ◽  
Matthew Press ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Health Care ◽  
Mental Health Care ◽  
Primary Care Providers ◽  
Depression Symptoms ◽  
Care Providers ◽  
Mild Depression ◽  
Significant Depression ◽  
Clinically Significant

Abstract Introduction Past epidemiological research indicates that insomnia and depression are both highly prevalent and tend to co-occur in the general population. The present study further assesses this association by estimating: (1) the concurrence rates of insomnia and depression in outpatients referred by their primary care providers for mental health care; and (2) whether the association between depression and insomnia varies by insomnia subtype (initial, middle, and late). Methods Data were collected from 3,174 patients (mean age=42.7; 74% women; 50% Black) who were referred to the integrated care program for assessment of mental health symptoms (2018–2020). All patients completed an Insomnia Severity Index (ISI) and a Patient Health Questionnaire (PHQ-9) during their evaluations. Total scores for the ISI and PHQ-9 were computed. These scores were used to categorize patients into diagnostic groups for insomnia (no-insomnia [ISI < 8], subthreshold-insomnia [ISI 8–14], and clinically-significant-insomnia [ISI>14]) and depression (no-depression [PHQ-914]). Items 1–3 of the ISI were also used to assess the association between depression and subtypes of insomnia. Results Rates of insomnia were as follows: 34.6% for subthreshold-insomnia, 35.5% for clinically-significant insomnia, and 28.9% for mild-depression and 26.9% for clinically-significant-depression. 92% of patients with clinically significant depression reported at least subthreshold levels of insomnia. While the majority of patients with clinical depression reported having insomnia, the proportion of patients that endorsed these symptoms were comparable across insomnia subtypes (percent by subtype: initial insomnia 63%; middle insomnia 61%; late insomnia 59%). Conclusion According to these data, the proportion of outpatients referred for mental health evaluations that endorse treatable levels of insomnia is very high (approximately 70%). This naturally gives rise to at least two questions: how will such symptomatology be addressed (within primary or specialty care) and what affect might targeted treatment for insomnia have on health were it a focus of treatment in general? Support (if any) Vargas: K23HL141581; Perlis: K24AG055602

Introducing Shared Mental Health Care in Northwestern Ontario: An Analysis of Changing Referral Patterns of Primary Care Providers

2015 ◽  
Vol 34 (2) ◽  
pp. 63-72 ◽  
Author(s):  
Graham Gaylord ◽  
S. Kathleen Bailey ◽  
John M. Haggarty
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Health Care ◽  
Mental Health Services ◽  
Health Services ◽  
Mental Health Care ◽  
Community Mental Health Services ◽  
Primary Care Providers ◽  
Care Providers ◽  
Referral Patterns

This study describes a shared mental health care (SMHC) model introduced in Northern Ontario and examines how its introduction affected primary care provider (PCP) mental health referral patterns. A chart review examined referrals (N = 4,600) from 5 PCP sites to 5 outpatient community mental health services from January 2001 to December 2005. PCPs with access to SMHC made significantly more mental health referrals (p < 0.001). Two demographically similar PCPs were then compared, one co-located with SMHC. Referrals for depression to non-SMHC mental health services were 1.69 times more likely to be from the PCP not co-located with SMHC (p < 0.001). Findings suggest SMHC increases access to care and decreases demand on existing mental health services.

The Experience of Primary Care Providers With an Integrated Mental Health Care Program in Safety-Net Clinics

2015 ◽  
Vol 38 (2) ◽  
pp. 158-168 ◽  
Author(s):  
Wayne D. Bentham ◽  
Anna Ratzliff ◽  
David Harrison ◽  
Ya-Fen Chan ◽  
Steven Vannoy ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Health Care ◽  
Care Program ◽  
Primary Care Providers ◽  
Safety Net ◽  
Care Providers ◽  
Health Care Program ◽  
Safety Net Clinics ◽  
Integrated Mental Health
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