Towards integrated medical and mental healthcare in the inpatient setting: what is the role of psychology?

Pudalov, Lauren R; Swogger, Marc T.; Wittink, Marsha N.

doi:10.1080/09540261.2018.1552125

Cited by 10 publications

(10 citation statements)

References 103 publications

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“…Emerging evidence shows that well-integrated care can improve the quality of health care and several patient outcomes (23)(24)(25). Therefore, healthcare professionals should take a holistic approach to health care for the benefit of the patient (26,27), and all of the above mentioned barriers to somatic health care should be tackled with this basic idea in mind. For example, information sharing systems within and across different healthcare services, shared protocols between mental and somatic health services, and co-location of services can help solve problems regarding data transfer and unclear roles and responsibilities, and remove barriers to delivering integrated care (28).…”

Section: Discussionmentioning

confidence: 99%

Barriers to Somatic Health Care for Persons With Severe Mental Illness in Belgium: A Qualitative Study of Patients' and Healthcare Professionals' Perspectives

et al. 2022

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BackgroundA huge and still growing mortality gap between people with severe mental illness (SMI) and the general population exists. Physical illnesses, mainly cardiovascular diseases, substantially contribute to the high mortality rates in patients with SMI. Disparities in somatic health care access, utilisation, and provision contribute to these poor physical health outcomes.MethodsA qualitative study, using semi-structured interviews, was set up to explore SMI patients' and healthcare professionals' perspectives on somatic health care in different psychiatric settings of the three Belgian regions (Flanders, Brussels, Wallonia). Interviews were digitally recorded and transcribed prior to qualitative inductive thematic analysis, using Nvivo software. The COnsolidated criteria for REporting Qualitative research (COREQ) were used for reporting methods and findings.ResultsCollaboration and information flows between psychiatric healthcare professionals, non-psychiatric healthcare professionals, and persons with SMI were troublesome. This seemed to be mainly due to stigma and prejudice and challenging communication and data transfer. Lack of sufficient training and experience to identify and treat somatic health problems in people with SMI (for psychiatrists and psychiatric nurses) and lack of psychiatric knowledge and feeling or sensitivity for psychiatric patients (for non-psychiatric healthcare professionals) further complicated adequate somatic health care. Finally, optimal somatic follow-up of patients with SMI was hampered by organisational problems (unavailability of equipment, unadapted infrastructure, understaffing, hospital pharmacy issues, and insufficient health promotion/lifestyle interventions), patient-related issues (unawareness of physical problems, non-adherence, need for accompaniment) and financial barriers.ConclusionThere is an urgent need for integrated somatic and mental healthcare systems and a cultural change. Psychiatrists and primary care providers continue to consider the mental and physical health of their patients as mutually exclusive responsibilities due to a lack of sufficient training and experience, poor or absent liaison links, time constraints and organisational and financial barriers. Modifying these aspects will improve the quality of somatic health care for these vulnerable patients.

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Section: Discussionmentioning

confidence: 99%

Barriers to Somatic Health Care for Persons With Severe Mental Illness in Belgium: A Qualitative Study of Patients' and Healthcare Professionals' Perspectives

et al. 2022

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“…REHABILITATION PSYCHOLOGY STATE OF THE FIELD 7 worth of the individual provider in this field is understanding how to measure and communicate the "value-added services" and "indirect benefits" that Rehabilitation Psychologists provide to the organizations for which they work (American Psychological Association, 2018aAssociation, , 2018bBarisa, 2010;Giusti et al, 2017;Prince et al, 2007;Pudalov et al, 2018). For example:…”

Section: Discussionmentioning

confidence: 99%

“…While the revenue side of our work cannot be ignored, the value of Rehabilitation Psychology cannot be measured by the reimbursement of clinical services alone. The key to demonstrating the worth of the individual provider in this field is understanding how to measure and communicate the “value-added services” and “indirect benefits” that Rehabilitation Psychologists provide to the organizations for which they work (American Psychological Association, 2018a, 2018b; Barisa, 2010; Giusti et al, 2017; Prince et al, 2007; Pudalov et al, 2018). For example: Identification of activities that produce significant cost savings or result in additional downstream revenue.…”

Section: Discussionmentioning

confidence: 99%

Rehabilitation psychology: 2020 state of the field survey.

Baker¹,

Karol²,

Stern³

et al. 2022

Rehabilitation Psychology

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Purpose/Objective: To date, there are no published formal surveys of the "state of the field" of Rehabilitation Psychology in terms of education, training, practice patterns, professional identity, and relative salary and income structures for those who identify as Rehabilitation Psychologists. Research Method/Design: In an effort to gather this information, the Practice Committee of APA Division 22 (Rehabilitation Psychology) conducted a convenience-sample survey of its listserv subscribers to obtain a representation of Rehabilitation Psychologists across the United States, and a depiction of the fields in which they work. Results: There were 282 respondents to the survey. Most respondents were female (69%) and worked in hospital/medical facilities (70%). Most worked in urban/suburban areas (96%), with adults (57%), and had a straight salary income structure (78%). Salary was found to be associated with age (p , .001), gender (p , .001), degree (p = .001), board certification status (p , .001), years licensed (p , .001), and Manager/Director position status (p , .001). Salary was not significantly different by region. Conclusions: Implications regarding the need for advocacy for the roles of Rehabilitation Psychology in health care, promotion of the specialty with consumers, and the development of future professionals are discussed. Impact and ImplicationsThis article provides information on Rehabilitation Psychologist's current roles, education, boardcertification status, demographic information, and income. Discussion focuses on the larger impact of the current state of the field, and considerations for future growth and development, including advocacy for the field in the changing healthcare landscape. Recommendations include future updated and improved surveys to assist the field in current healthcare position negotiations and future implications.

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“…This is also the first paper to propose the idea of an ITT within an inpatient mental health setting. While there is a lack of papers focusing on inpatient multi-disciplinary working, some findings suggest that adapting services so that they are more psychologically informed has a positive impact on patient care and the wider system (Acrai and Clarke, 2017; Kerfoot et al , 2012; Pudalov et al , 2018). MDT members have highlighted the value of a more psychologically oriented perspective and have noted the importance of increasing this (Wood et al , 2019a).…”

Section: Discussionmentioning

confidence: 99%

Working with the chaos in an adult inpatient mental health setting: the role of an integrated therapies team

Cotter

Papasileka

Eugster

et al. 2022

MHSI

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Purpose The purpose of this study is to outline a process-oriented psychology informed view of the impact of ever-increasing acuity within an adult inpatient system and conceptualise how an integrated therapies team (ITT) can work with the chaos that this brings. Design/methodology/approach A reflective scientist-practitioner based approach was used over a two-year period. Findings Several factors lead to “chaos” in an inpatient unit, including societal inequality, the trauma and adversity it creates and the impact of this at a systemic, interpersonal and intrapersonal level. Chaos is one means of coping and can dominate inpatient working, whereas understanding the underlying distress is often marginalised. Developing an ITT can support working with chaos. The ITT holds the therapeutic perspective for the wider multi-disciplinary team (MDT) and therapeutic and facilitation skills are central to how it operates. Processing the chaos and working with the underlying distress is its overarching function. Practical implications Developing an ITT offers a robust structure for evolving inpatient MDT working to cope with increasing acuity in a psychologically informed way. Social implications The chaos in question is often viewed as patients’ issue but from a collectivist perspective it is something that all members of society are responsible for. Originality/value To the best of the authors’ knowledge, this is the first paper to conceptualise the chaos on an inpatient ward as a process needed by the system as a way of coping and propose the addition of an ITT to inpatient working.

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Towards integrated medical and mental healthcare in the inpatient setting: what is the role of psychology?

Cited by 10 publications

References 103 publications

Barriers to Somatic Health Care for Persons With Severe Mental Illness in Belgium: A Qualitative Study of Patients' and Healthcare Professionals' Perspectives

Barriers to Somatic Health Care for Persons With Severe Mental Illness in Belgium: A Qualitative Study of Patients' and Healthcare Professionals' Perspectives

Rehabilitation psychology: 2020 state of the field survey.

Working with the chaos in an adult inpatient mental health setting: the role of an integrated therapies team

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