Coordinating Mental and Physical Health Care in Rural Australia: An Integrated Model for Primary Care Settings

Abstract

Introduction:The ‘GP Clinic’ provides primary health care to people using community mental health services in a small town in Australia. This article examines the factors that have driven successful integration in this rural location.Methods:A multiple methods case study approach was used comprising service record data for a 24 month period and semi-structured interviews with sixteen staff members associated with the integrated rural service model.Results:Processes and structures for establishing integrated care evolved locally from nurturing supportive professional and organisational relationships. A booking system that maximised attendance and minimised the work of the general practice ensured that issues to do with remuneration and the capacity for the general practitioner to provide care to those with complex needs were addressed. Strong collaborative relationships led to the upskilling of local staff in physical and mental health conditions and treatments, and ensured significant barriers for people with mental illness accessing primary care in rural Australia were overcome.Conclusions:Integrated physical and mental health service models that focus on building local service provider relationships and are responsive to community needs and outcomes may be more beneficial in rural settings than top down approaches that focus on policies, formal structures, and governance.

Screening and referral is not enough: a qualitative exploration of barriers to access and uptake of mental health services in patients with cardiovascular diseases

“…Further implementation of collaborative care across healthcare systems may be beneficial. Collaborative care can also facilitate the upskilling of staff regarding mental health [ 44 ], which may help to redress information provision barriers. The practical barriers identified in thus study, such as high volume of medical appointments associated with physical health conditions, along with transport and access issues, may also be partly overcome with a blended collaborative care approach [ 42 ].…”

Relationships Among Structures, Team Processes, and Outcomes for Service Users in Quebec Mental Health Service Networks

“…The concentration of all managers from the Urban MHSN within a single category (category 3) is more difficult to explain, since primary care teams were located in a HSSC and specialized services in a MH university institute, similar to the Metropolitan MHSN. It is possible that the primary care and specialized MH teams had successfully created an integrated vision and practices, which are usually reported as positively associated with better quality and continuity of care [32]. The accumulation of high ER users in the Urban MHSN might explain the frequent use of clinical procedures, tools and approaches.…”

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Screening and Referral is Not Enough: A Qualitative Exploration of Barriers to Access and Uptake of Mental Health Services in Patients With Cardiovascular Diseases

“…Further implementation of collaborative care across healthcare systems may be bene cial. Collaborative care can also facilitate the upskilling of staff regarding mental health (44), which may help to redress information provision barriers.…”