Integrating mental health services into primary care for HIV-infected pregnant and non-pregnant women: whole life—a theoretically derived model for clinical care and outcomes assessment

Dodds, Sally; Blaney, Nancy T.; Nuehring, Elane M.; Blakley, Theresa; Lizzotte, Jean Marie; Potter, JoNell; OʼSullivan, Mary J.

doi:10.1016/s0163-8343(00)00090-6

Cited by 19 publications

(12 citation statements)

References 80 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…92,95 Primary care physicians have been challenged to play a larger role in addressing patients' mental health needs. [96][97][98][99][100] Some clinical models use a mental health team in the primary care clinic to rapidly evaluate and stabilize patients, and educate the primary care clinical staff. 99,100 In these integrated approaches receipt of mental health services increase, referrals decrease, patients benefit by continuing to be treated by their primary care physicians, and physicians benefit from additional support and training from mental health professionals.…”

Section: Insufficient Linkage Of Addiction Treatment and Primary Medimentioning

confidence: 99%

The Case for Chronic Disease Management for Addiction

Saitz

Larson

LaBelle

et al. 2008

Journal of Addiction Medicine

128

102

View full text Add to dashboard Cite

Chronic disease (care) management (CDM) is a patient-centered model of care that involves longitudinal care delivery; integrated, and coordinated primary medical and specialty care; patient and clinician education; explicit evidence-based care plans; and expert care availability. The model, incorporating mental health and specialty addiction care, holds promise for improving care for patients with substance dependence who often receive no care or fragmented ineffective care. We describe a CDM model for substance dependence and discuss a conceptual framework, the extensive current evidence for component elements, and a promising strategy to reorganize primary and specialty health care to facilitate access for people with substance dependence. The CDM model goes beyond integrated case management by a professional, colocation of services, and integrated medical and addiction care-elements that individually can improve outcomes. Supporting evidence is presented that: 1) substance dependence is a chronic disease requiring longitudinal care, although most patients with addictions receive no treatment (eg, detoxification only) or short-term interventions, and 2) for other chronic diseases requiring longitudinal care (eg, diabetes, congestive heart failure), CDM has been proven effective. Keywordschronic disease management; addiction; primary care; linkage; addiction treatment; chronic care model; recovery Substance (alcohol and drug) dependence is a chronic disease for which many affected adults receive no intervention or detoxification without subsequent treatment. Like other chronic diseases (eg, diabetes, congestive heart failure), substance dependence has no cure and is characterized by relapses requiring longitudinal care. Medical and psychiatric comorbidities are the rule rather than the exception. As a result, care delivery can be complex both for clinicians and patients. In the United States, systems of care for substance dependence (both alcohol and drug) are rarely integrated with those for medical and psychiatric illnesses. Specialty alcohol and drug treatment is efficacious, but many patients do not access available treatment for substance dependence problems after detoxification or medical care. Others enter NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript specialty addiction treatment but do not receive medical or psychiatric care. Some have called to expand the frame of health services research on addictions to include services outside the specialty treatment sector, including behavioral care integrated into primary care. [1][2][3] Although primary care settings provide the venue for longitudinal, comprehensive, and coordinated care, their potential to effectively treat addiction and related comorbidities has not been realized; medical, mental health, and addiction treatment are not coordinated. Primary care settings, with reorganization and appropriate service elements, hold the promise of simultaneously improving physical and psychiatric health while decreasing substan...

show abstract

Section: Insufficient Linkage Of Addiction Treatment and Primary Medimentioning

confidence: 99%

The Case for Chronic Disease Management for Addiction

Saitz

Larson

LaBelle

et al. 2008

Journal of Addiction Medicine

128

102

View full text Add to dashboard Cite

show abstract

“…Integrated treatment is a means of actively combining interventions intended to address substance use and mental disorders in order to treat both disorders, related problems, and the whole person more effectively. (Center for Substance Abuse Treatment, 2004, p. 12) During the last decade, integrated treatment has continued to evolve, and several treatment models based on experience in mental health systems have been described (Center for Substance Abuse Treatment, 2004;Drake & Mueser, 1996;Lehman & Dixon, 1995;Minkoff & Drake, 1991;Zimberg, 1993), along with comparable examples from addiction settings (Charney et al, 2001;McLellan et al, 1993;Saxon & Calsyn, 1995;Weisner et al, 2001) and medical clinics (Dodds et al, 2000;Kobayashi & Standridge, 2000). The successful addition of psychiatric and mental health services to methadone treatment has been demonstrated (Kraft et al, 1997;Woody et al, 1983).…”

Section: Deliver Integrated Treatmentmentioning

confidence: 99%

Mental disorders and drug abuse in persons living with HIV/AIDS

2004

View full text Add to dashboard Cite

This article reviews the literature on the prevalence of mental and substance use disorders among persons living with HIV/AIDS. Drug use, both injection and non-injection, substantially increases the risk for HIV infection. While injection drug users have the highest prevalence rates for HIV, substantially elevated rates of HIV infection are also present among crack cocaine users and individuals with substance use disorders generally. Persons with HIV/AIDS and a mental and/or substance use disorder have highly variable patterns of accessing services. Persons with HIV/AIDS who have a serious mental illness are more highly involved with services than other groups. Most individuals with co-occurring disorders report some involvement with outpatient primary medical care, although ancillary services such as mental health and substance abuse treatment, transportation assistance, and case management improve involvement in medical care. Women with HIV/AIDS and co-occurring mental and substance use disorders experience unique vulnerabilities, particularly those related to exposure to traumatic events. Given the complexity of needs with which triply or multiply diagnosed individuals present, effective treatment programmes are likely to be those that provide some degree of integrated care.

show abstract

“…The 2007 National HIV Prevention Conference identified poverty, lack of education, mental illness, substance abuse, and discrimination as being antecedents to HIV/AIDS because of increased chances of engaging in risky sexual and drug-use behaviors and called for treatment of these root causes (Fullilove et al, 2007). Because racial and ethic minority women are likely to fit this profile, they are more vulnerable to mental illness, substance abuse, and subsequent seroconversion (Catz, Gore-Felton, & McClure, 2002;Dodds et al, 2000;Dodds et al, 2004;Sullivan et al, 1999). Seropositive women have higher rates of mental illness including depression (30Á80%) and substance use (25Á66%) than the general population and men (Brief et al, 2004;Catz et al, 2002;Cohen et al, 2000;Dodds et al, 2004;Hackl, Somlai, Kelly, & Kalichman, 1997;Hudson, Kirksey, & Holzemer, 2004;Klinkenberg & Sacks, 2004;Taylor, Burnam, Sherbourne, Andersen, & Cunningham, 2004).…”

Section: Introductionmentioning

confidence: 99%

Case manager-reported utilization of support group, substance use and mental health services among HIV-positive women in New York City

et al. 2009

View full text Add to dashboard Cite

A retrospective, longitudinal analysis of case management and medical charts was used to evaluate utilization of support group, mental health, and substance abuse treatment services among HIV-positive women in New York City. Analyses of 4134 case management and supportive service transactions revealed that 70% utilized support groups over the two-year study period. In contrast, only 35% utilized mental health services (therapy) and of those identified as using substances, only 48% utilized substance abuse treatment services. Considering the high prevalence of mental illness (63%, n=29) and substance use (54%, n=25) in the sample, the low utilization rates highlight unmet needs for service. Significant differences were found in utilization of mental health and substance abuse treatment services, with those who received services at a medical model agency (integrated care) being more likely to receive both types of treatment. In contrast, participants attending support groups in non-medical model agencies (77.8%, n=7) were significantly more likely to be retained in group (i.e., attend 11 or more sessions) than those at medical model agencies (39.1%, n=9). Based on the higher utilization rates of support groups among seropositive women, perhaps these groups could be a vehicle for establishing rapport between mental health professionals and group members to bridge the utilization gap and reduce the stigma associated with therapy and substance abuse treatment services. These findings both taut the success and highlight weaknesses regarding accessing mental health and substance abuse care, and support group retention. Sharing of information regarding recruitment and retention efforts between agencies of different modalities would be beneficial and also could identify service niches that capitalize on their subsequent strengths.

show abstract

Integrating mental health services into primary care for HIV-infected pregnant and non-pregnant women: whole life—a theoretically derived model for clinical care and outcomes assessment

Cited by 19 publications

References 80 publications

The Case for Chronic Disease Management for Addiction

The Case for Chronic Disease Management for Addiction

Mental disorders and drug abuse in persons living with HIV/AIDS

Case manager-reported utilization of support group, substance use and mental health services among HIV-positive women in New York City

Contact Info

Product

Resources

About