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(887 results for Integrated Primary Care Service)

Integrated Primary Care Service

Fragmentation of physical, mental and chemical dependency care delivery systems has caused significant gaps in care for individuals with serious mental illness and substance use disorders. These individuals have disproportionately high rates of physical health conditions, making them especially vulnerable to gaps in fragmented care.

During the past several decades, coordinated care service delivery models connecting behavioral and physical health have led to promising integrative and collaborative approaches. Behavioral health integration (BHI) is a client-centered approach in which behavioral health and medical providers work collaboratively to treat individuals with mental health disorders. State and local BHI initiatives utilize a variety of approaches in developing programs. Evidence supports the effectiveness of integrating behavioral health into primary care settings for adults with depression and anxiety disorders, however, far less evidence exists analyzing this model for people with substance use disorders and serious mental illness.

BHI Implementation Barriers

Key areas identified as potential barriers include:

– Identifying and defining target populations who would benefit from BHI
– Care management, consultations and communication activities among providers are not reimbursed under typical fee-for-service plans
– Fragmentation of behavioral health services and medical care in managed care plans
– Provider and organizational capacity issues such as workforce training and support requirements
– Facilitating use of information-sharing and technology
– Resistance to change such as hiring new staff, incorporating new roles and balancing competing demands

Outcome Studies

Researchers conducted 12 randomized controlled trials on adults with bipolar disorder (three studies, 832 participants), other serious mental illnesses (three studies, 666 participants) and chemical dependency (five studies, 2,000 participants). The findings were not statistically conclusive, but yielded some promise.

– Care management may moderately improve mental health symptoms and mental health-related quality of life for clients with bipolar disorder and serious mental illness.
– Fully integrated care and care management may moderately improve use of preventive and medical services and may slightly improve physical health symptoms and quality of life for clients with bipolar disorder and serious mental illness.
– Incorporating primary care into chemical dependency treatment settings without enhanced coordination and collaboration does not improve mental or physical health outcomes.

Integrating mental health services into primary care settings has the potential for ensuring efficient, easy access to mental health services. More research is needed to justify and encourage implementation, in particular outcome studies assessing the cost effectiveness of these programs.

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More on Integrated Primary Care Service

Fragmentation of physical, mental and chemical dependency care delivery systems has caused significant gaps in care for individuals with serious mental illness and substance use disorders. These individuals have disproportionately high rates of physical health conditions, making them especially vulnerable to gaps in fragmented care.

During the past several decades, coordinated care service delivery models connecting behavioral and physical health have led to promising integrative and collaborative approaches. Behavioral health integration (BHI) is a client-centered approach in which behavioral health and medical providers work collaboratively to treat individuals with mental health disorders. State and local BHI initiatives utilize a variety of approaches in developing programs. Evidence supports the effectiveness of integrating behavioral health into primary care settings for adults with depression and anxiety disorders, however, far less evidence exists analyzing this model for people with substance use disorders and serious mental illness.

BHI Implementation Barriers

Key areas identified as potential barriers include:

– Identifying and defining target populations who would benefit from BHI
– Care management, consultations and communication activities among providers are not reimbursed under typical fee-for-service plans
– Fragmentation of behavioral health services and medical care in managed care plans
– Provider and organizational capacity issues such as workforce training and support requirements
– Facilitating use of information-sharing and technology
– Resistance to change such as hiring new staff, incorporating new roles and balancing competing demands

Outcome Studies

Researchers conducted 12 randomized controlled trials on adults with bipolar disorder (three studies, 832 participants), other serious mental illnesses (three studies, 666 participants) and chemical dependency (five studies, 2,000 participants). The findings were not statistically conclusive, but yielded some promise.

– Care management may moderately improve mental health symptoms and mental health-related quality of life for clients with bipolar disorder and serious mental illness.
– Fully integrated care and care management may moderately improve use of preventive and medical services and may slightly improve physical health symptoms and quality of life for clients with bipolar disorder and serious mental illness.
– Incorporating primary care into chemical dependency treatment settings without enhanced coordination and collaboration does not improve mental or physical health outcomes.

Integrating mental health services into primary care settings has the potential for ensuring efficient, easy access to mental health services. More research is needed to justify and encourage implementation, in particular outcome studies assessing the cost effectiveness of these programs.

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