Effect of mental health collaborative care models on primary care provider outcomes: an integrative review

Abstract

Background Collaborative care models (CCMs) have robust research evidence in improving mental health outcomes for diverse patient populations with complex health care needs. However, the impact of CCMs on primary care provider (PCP) outcomes are not well described. Objective This integrative review synthesizes the evidence regarding the effect of mental health CCMs on PCP outcomes. Methods PubMed, CINAHL, Web of Science, and PsycInfo were systematically searched using key terms, with inclusion criteria of English language, peer-reviewed literature, primary care setting, PCP outcomes, and mental health CCM. This resulted in 1,481 total records, with an additional 14 records identified by review of reference lists. After removal of duplicates, 1,319 articles were reviewed based on title and abstract, 190 full-text articles were assessed, and a final selection of 15 articles were critically appraised and synthesized. Results The articles included a wide variety of sample sizes, designs, settings, and patient populations, with most studies demonstrating low or moderate quality evidence. Although CCMs had an overwhelmingly positive overall effect on PCP outcomes such as knowledge, satisfaction, and self-efficacy, multiple logistical barriers were also identified that hindered CCM implementation such as time and workflow conflicts. Adaptability of the CCM as well as PCP enthusiasm enhanced positive outcomes. Newer-to-practice PCPs were more likely to participate in CCM initiatives. Conclusion Accumulating evidence supports CCM expansion, to improve both patient and PCP outcomes. Logistical efforts may enhance CCM adaptability and workflow. Further studies are needed to specifically examine the effect of CCMs on PCP burnout and retention.

Effectiveness of Agreement Criteria and Flows of Collaborative Care in Primary Mental Health Care in Brazil

“…Towards this direction, there are initiatives, such as Improving Access to Psychological Therapies (IAPT), which belongs to National Health Service of the United Kingdom, the Dutch initiative to Depression, and the Australian model TrueBlue, although they do not reach all patients with mental disorders and do not include, on a daily basis, most health aspects [ 13 ]. Although positive effects are present in the PHC model, such as users’ satisfaction and effectiveness of care, there are conflicts among professionals related to treatment time length and full-flow design to make collaborative work [ 18 ].…”

“…Before and after the COVID-19 pandemic, mental and behavioral health disorders had a global burden, recently estimated at 13%, broadening the magnitude of personal, social, and economic mental disorders costs [ 17 ] and increasing health system requirements, which are already burdened and focused in specialties, with the integration of care in the PHC environment as one of the solutions to heath care needs [ 13 ]. The CoCM is developed through interprofessional care actions in the PHC, including a behavioral health care manager, who is trained to work together with PHC professionals, and assessment about mental health needs of the specified population with the review of results through supervision of a designated psychiatric consultant [ 15 , 18 ]. Nevertheless, health care actions and services with the offer of care plans focused on evidence related to ordinary mental disorders such as depression and anxiety in the primary care background [ 19 ].…”

Developing a Collaborative Approach to Support Access and Acceptability of Mental Health Care for Refugee Youth: An Exploratory Case Study with Young Afghan Refugees

“…Collaborative mental health care (CMHC) [ 55 , 56 ] is a model of psychosocial care developed in Canada as a systemic approach to enable access to marginalized communities through embedding specialized mental health care professionals in primary care settings. These specialized mental health consultants coordinate collaborative, interdisciplinary, intersectoral and intercultural networks surrounding children and family, actively including patients’ minority voices.…”

The Community Primary Care Champions Fellowship: A Mixed Methods Evaluation of an Interprofessional Fellowship for Physician Assistants and Physicians

“…A key component for successful primary care transformation is interprofessional collaboration and teambased care (10,11). Team-based care has been shown to bene t clinical practice in various ways, including better patient outcomes, fewer medical errors, improved team e ciency and cohesiveness, and a positive impact on clinician well-being (12)(13)(14)(15)(16)(17)(18). Furthermore, practice features that include team-based care addressing the social and behavioral health needs of patients, support quality improvement (QI) initiatives, and provide professional development and teaching opportunities, have been shown to be protective against primary care workforce burnout and turnover (12,13,16,19,20).…”