Evolving Models of Behavioral Health

Collins, Chris; Hewson, Denise Levis; Munger, Richard L.; Wade, Torlen

doi:10.1599/evolvingcare2010

Cited by 258 publications

(235 citation statements)

References 9 publications

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“…6,32,33 PCPs are often the first encounter families have with mental health care, and this encounter can affect how families engage in treatment and future help-seeking behavior. 34,35 However, research suggests that PCPs are not immune to the effects of culture and class-related biases. 36 For example, providers who were presented with clients described as having lower SES appeared less inclined to work with them and were more likely to view them as having a mental illness.…”

Section: Barriers To Accessing and Using Mental Health Servicesmentioning

confidence: 99%

“…53 Integrated behavioral health care in the PCMH is a new concept that is still taking shape in practice and currently exists in many different forms, ranging from routine mental health screening as part of well child care to colocation of mental health providers within a primary care practice. These models of care, described in greater detail below, can decrease stigma, allow easier access to services in a trusted setting, and facilitate better communication and collaboration between medical and behavioral health providers, 34,53,54 addressing many of the barriers that children and families experiencing poverty face in accessing care. 53 -57 Families with children who have behavioral problems tend to use pediatric services more than other families, 58 thus increasing the opportunity for primary care to serve as an entryway into mental health care.…”

Section: Strategies To Improve Mental Health Access and Outcomes In Pmentioning

confidence: 99%

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Improving Mental Health Access for Low-Income Children and Families in the Primary Care Setting

et al. 2017

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Poverty is a common experience for many children and families in the United States. Children <18 years old are disproportionately affected by poverty, making up 33% of all people in poverty. Living in a poor or low-income household has been linked to poor health and increased risk for mental health problems in both children and adults that can persist across the life span. Despite their high need for mental health services, children and families living in poverty are least likely to be connected with high-quality mental health care. Pediatric primary care providers are in a unique position to take a leading role in addressing disparities in access to mental health care, because many low-income families come to them first to address mental health concerns. In this report, we discuss the impact of poverty on mental health, barriers to care, and integrated behavioral health care models that show promise in improving access and outcomes for children and families residing in the contexts of poverty. We also offer practice recommendations, relevant to providers in the primary care setting, that can help improve access to mental health care in this population.

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Section: Barriers To Accessing and Using Mental Health Servicesmentioning

confidence: 99%

Section: Strategies To Improve Mental Health Access and Outcomes In Pmentioning

confidence: 99%

Improving Mental Health Access for Low-Income Children and Families in the Primary Care Setting

et al. 2017

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“…43 For PCPs with mostly younger patients, better integration of primary care and behavioral health teams may be more effective. 44,45 For this study, we primarily used electronically available patient data, which allowed us to construct a conceptual framework for effort and complexity in primary care at the population level, but did not provide enough granularity to further segment patients into clinically actionable subgroups. Although our network includes a variety of practice types, including community health centers, findings from a single health system may not be generalizable to other primary care networks.…”

Section: Discussionmentioning

confidence: 99%

Defining Team Effort Involved in Patient Care from the Primary Care Physician’s Perspective

et al. 2016

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BACKGROUND: A better understanding of the attributes of patients who require more effort to manage may improve risk adjustment approaches and lead to more efficient resource allocation, improved patient care and health outcomes, and reduced burnout in primary care clinicians. OBJECTIVE: To identify and characterize high-effort patients from the physician's perspective. DESIGN: Cohort study. PARTICIPANTS: Ninety-nine primary care physicians in an academic primary care network. MAIN MEASURES: From a list of 100 randomly selected patients in their panels, PCPs identified patients who required a high level of team-based effort and patients they considered complex. For high-effort patients, PCPs indicated which factors influenced their decision: medical/ care coordination, behavioral health, and/or socioeconomic factors. We examined differences in patient characteristics based on PCP-defined effort and complexity. KEY RESULTS: Among 9594 eligible patients, PCPs classified 2277 (23.7 %) as high-effort and 2676 (27.9 %) as complex. Behavioral health issues were the major driver of effort in younger patients, while medical/care coordination issues predominated in older patients. Compared to low-effort patients, high-effort patients were significantly (P < 0.01 for all) more likely to have higher rates of medical (e.g. 23.2 % vs. 6.3 % for diabetes) and behavioral health problems (e.g. 9.8 % vs. 2.9 % for substance use disorder), more frequent primary care visits (10.9 vs. 6.0 visits), and higher acute care utilization rates (25.8 % vs. 7.7 % for emergency department [ED] visits and 15.0 % vs. 3.9 % for hospitalization). Almost one in five (18 %) patients who were considered high-effort were not deemed complex by the same PCPs. CONCLUSIONS: Patients defined as high-effort by their primary care physicians, not all of whom were medically complex, appear to have a high burden of psychosocial issues that may not be accounted for in current chronic disease-focused risk adjustment approaches.KEY WORDS: primary care redesign; psychosocial; health services research; resource allocation; risk adjustment.

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“…Principles were 'affirmative action' and a 'whole of system approach'. 53 The policy reform proposals were broad and integrative: recognising the potential of the MHNIP 83 for providing more comprehensive care, considering recreational opportunities for physical activity outside the healthcare system and locating state-based systems within a national reform process led by the Council of Australian Governments. Although the Report 53 provided detailed actions and recommendations to the State Government, no follow-up policy development by the Victorian Government could be found.…”

Section: State Policiesmentioning

confidence: 99%

Applying the World Health Organization Mental Health Action Plan to evaluate policy on addressing co-occurrence of physical and mental illnesses in Australia

Happell

Platania‐Phung

Webster³

et al. 2015

Aust. Health Review

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Objectives. The aim of the present study was to document Australian policies on the physical health of people with mental illness and evaluate the capacity of policy to support health needs.Methods. A search of state and federal policies on mental and physical illness was conducted, as well as detailed analysis of policy content and the relationships between policies, by applying the World Health Organization Mental Health Action Plan 2013-2020 as an evaluative framework.

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Evolving Models of Behavioral Health

Cited by 258 publications

References 9 publications

Improving Mental Health Access for Low-Income Children and Families in the Primary Care Setting

Improving Mental Health Access for Low-Income Children and Families in the Primary Care Setting

Defining Team Effort Involved in Patient Care from the Primary Care Physician’s Perspective

Applying the World Health Organization Mental Health Action Plan to evaluate policy on addressing co-occurrence of physical and mental illnesses in Australia

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