Integrating Behavioral Health Services into Primary Care: Spotlight on the Primary Care Behavioral Health (PCBH) Model of Service Delivery

Hunter, Christopher L.; Dobmeyer, Anne C.; Reiter, Jeffrey T.

doi:10.1007/s10880-017-9534-7

Cited by 13 publications

(3 citation statements)

References 19 publications

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“…Integrating CBGS within existing health outreach activities was fronted as one of the avenues for advancing the community geriatric support agenda. The integration of health services is less costly, more acceptable since community members receive comprehensive services and adaptable to countries with human resource for health gaps [46][47][48]. In Uganda, studies have reported health services integration to be vital for improving refugee health services [49], HIV/AIDS and sexual reproductive health among youths in southwestern Uganda [50], and mental health [51].…”

Section: Discussionmentioning

confidence: 99%

‘… The Elderly are More Comfortable at Home Than at The Health Facility’. Primary Care Provider Notions On Instituting Community-Based Geriatric Support in Uganda

Ssensamba

Nakafeero

Musana

et al. 2021

Preprint

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Background Understanding of the most economical and sustainable models of providing geriatric care to Africa’s rising ageing population is critical. In Uganda, the number of old adults (60 years and above) continues to rise against absence of policies and guidelines, and models for providing care to this critical population. Our study explored public primary health care provider views on community-based geriatric support (CBGS) as an adaptable model for delivering geriatric care in Uganda’s resource-limited primary public health care settings. Methods We interviewed twenty key informants from four districts of Bukomansimbi, Kalungu, Rakai, and Lwengo in Southern Central Uganda. Respondents were leads (in-charges) of public primary health units that had spent at least six months at the fore said facilities. All interviews were audio-recorded, transcribed verbatim, and analysed based on Hsieh and Shannon’s approach to conventional manifest content analysis. Results During analysis, four themes emerged: 1) Structures to leverage for CBGS, 2) How to promote CBGS, 3) Who should be involved in CBGS, and 4) What activities need to be leveraged to advance CBGS? The majority of the respondents viewed using the existing village health team and local leadership structures as key to the successful institutionalization of CBGS; leveraging community education and sensitization using radio, television, and engaging health workers, family relatives, and neighbors. Health outreach activities were mentioned as one of the avenues that could be leveraged to provide CBGS. Conclusion Provider notions pointed to CBGS as a viable model for instituting geriatric care in Uganda’s public primary healthcare system. However, this requires policymakers to leverage existing village health team and local governance structures, conduct community education and sensitization about CBGS, and bring onboard health workers, family relatives, and neighbors.

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Section: Discussionmentioning

confidence: 99%

‘… The Elderly are More Comfortable at Home Than at The Health Facility’. Primary Care Provider Notions On Instituting Community-Based Geriatric Support in Uganda

Ssensamba

Nakafeero

Musana

et al. 2021

Preprint

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“…This primary care behavioral health model we created has continued to engage stakeholders in the health system and the community. 14 …”

Section: Methodsmentioning

confidence: 99%

Pediatric Trauma and Posttraumatic Symptom Screening at Well-child Visits

DiGiovanni

Frances

Brown

et al. 2023

Pediatric Quality &Amp; Safety

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Introduction: Adverse childhood experiences (ACEs), including abuse or neglect, parental substance abuse, mental illness, or separation, are public health crises that require identification and response. We aimed to increase annual rates of trauma screening during well-child visits from 0% to 70%, post-traumatic stress disorder (PTSD) symptom screening for children with identified trauma from 0% to 30%, and connection to behavioral health for children with symptoms from 0% to 60%. Methods: Our interdisciplinary behavioral and medical health team implemented 3 plan-do-study-act cycles to improve screening and response to pediatric traumatic experiences. Automated reports and chart reviews measured progress toward goals as we changed screening methods and provider training. Results: During plan-do-study-act cycle 1, a chart review of patients with positive trauma screenings identified various trauma types. During cycle 2, a comparison of screening methods demonstrated that written screening identified trauma among more children than verbal screening (8.3% versus 1.7%). During cycle 3, practices completed trauma screenings at 25,287 (89.8%) well-child visits. Among screenings, 2,441 (9.7%) identified trauma. The abbreviated Post Traumatic Stress Disorder Reaction Index was conducted at 907 (37.2%) encounters and identified 520 children (57.3%) with PTSD symptoms. Among a sample of 250, 26.4% were referred to behavioral health, 43.2% were already connected, and 30.4% had no connection. Conclusions: It is feasible to screen and respond to trauma during well-child visits. Screening method and training implementation changes can improve screening and response to pediatric trauma and PTSD. Further work is needed to increase rates of PTSD symptomology screening and connection to behavioral health.

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“…Unlike providers in traditional mental health settings, BHCs employ a population health model emphasizing collaboration with PCMs to deliver secondary and tertiary prevention services (e.g., universal screening, self-referrals; for more information about this model and its components, see Hunter & Goodie, 2012; Hunter, Dobmeyer, et al, 2018; Reiter et al, 2018). They use registries, patient records, and information from PCMs to identify patients who might be treated successfully with brief behavioral interventions, to include patients with mental health concerns as well as those presenting with problems typically outside the scope of specialty mental health such as insomnia or obesity (Brawer et al, 2010; Hunter, Dobmeyer, et al, 2018; Kessler, 2012; Robinson & Reiter, 2015). In order to deliver targeted patient identification and early intervention services, BHCs and their local managers require timely information on clinic case-mix and care patterns.…”

mentioning

confidence: 99%

Data-driven approaches to care delivery: Actionable informatics in the DoD’s primary care behavioral health program.

Kincaid

Peters

Curry

2021

Families, Systems, & Health

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Introduction: Transforming administrative health care data into meaningful metrics has been critical to the implementation of the Department of Defense's Primary Care Behavioral Health (PCBH) program. Methods: Data from clinical encounters with PCBH providers are used to develop metrics of program performance collaboratively. Metrics focus on describing the PCBH program and patients, provider fidelity to the model, and provider performance. These metrics form two key deliverables: a monitoring dashboard for program managers and a training dashboard for expert trainers conducting site visits. Results: Behavioral health consultants (BHCs) conducted nearly 200,000 encounters with more than 100,000 unique patients in fiscal year 2019 at more than 170 locations in 6 countries and 37 states. Administrative data derived from these encounters were used to create a variety of metrics that describe practice and performance at both the provider and program levels. These metrics are delivered through a variety of analytic products to stakeholders who use that information to make data-driven decisions about program direction and provider training. Discussion: We discuss examples of program management decisions and expert trainer actions based on these dashboards, highlighting the benefits of continued collaboration between analysts and program managers. Specifically, excerpts from several dashboards illustrate how penetration and productivity metrics yield specific, tailored action plans to improve care delivery and provider performance.

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Integrating Behavioral Health Services into Primary Care: Spotlight on the Primary Care Behavioral Health (PCBH) Model of Service Delivery

Cited by 13 publications

References 19 publications

‘… The Elderly are More Comfortable at Home Than at The Health Facility’. Primary Care Provider Notions On Instituting Community-Based Geriatric Support in Uganda

‘… The Elderly are More Comfortable at Home Than at The Health Facility’. Primary Care Provider Notions On Instituting Community-Based Geriatric Support in Uganda

Pediatric Trauma and Posttraumatic Symptom Screening at Well-child Visits

Data-driven approaches to care delivery: Actionable informatics in the DoD’s primary care behavioral health program.

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