This book goes some way to answering the questions of how the harm done by alcohol use can be prevented and managed in primary health care. It discusses strategies and approaches that can be adopted by primary health care providers in their everyday work with individuals and families, and outlines the possibilities for them to participate in community action and to advocate for healthy public policy on alcohol.
While there is a wealth of published information on addiction medicine, the psychological aspects of alcohol abuse, and behavioral medicine with regard to addiction, virtually none of these resources were written with the primary care provider in mind. Addressing Unhealthy Alcohol Use in Primary Care is a resource for primary care clinicians who are confronted by patients with these problems daily, and who wish to successfully address these issues in their practice. It would focus on the literature and science relevant to primary care practice and cover the range of interventions appropriate for this setting. Topics include assessment, brief counseling interventions, pharmacotherapy, referrals to both specialty care and Alcoholics Anonymous (and other self-help programs), psychiatric co-morbidity and other drug use, and other information specific to the needs of the primary care provider.
Behavioral health conditions, which include mental health and substance use disorders, affect approximately 20 percent of Americans. Of those with a substance use disorder, approximately 60 percent also have a mental health disorder. As many as 80 percent of patients with behavioral health conditions seek treatment in emergency rooms and primary care clinics, and between 60 and 70 percent of them are discharged without receiving behavioral health care services. More than two-thirds of primary care providers report that they are unable to connect patients with behavioral health providers because of a shortage of mental health providers and health insurance barriers. Part of the explanation for the lack of access to care lies in a historical legacy of discrimination and stigma that makes people reluctant to seek help and also led to segregated and inhumane services for those facing mental health and substance use disorders. In an effort to understanding the challenges and opportunities of providing essential components of care for people with mental health and substance use disorders in primary care settings, the National Academies of Sciences, Engineering, and Medicine's Forum on Mental Health and Substance Use Disorders convened three webinars held on June 3, July 29, and August 26, 2020. The webinars addressed efforts to define essential components of care for people with mental health and substance use disorders in the primary care setting for depression, alcohol use disorders, and opioid use disorders; opportunities to build the health care workforce and delivery models that incorporate those essential components of care; and financial incentives and payment structures to support the implementation of those care models, including value-based payment strategies and practice-level incentives. This publication summarizes the presentations and discussion of the webinars.
This book presents the largest international study of psychological disorders seen in primary health care. Centres in fourteen countries participated in this investigation, including Brazil, Chile, China, India, Nigeria and the USA as well as several European countries. The study has shown how people with mental disorders present their problems to doctors and how likely their disorders are to be detected and treated.
An integrated, collaborative model for more comprehensivepatient care Creating Effective Mental and Primary Health Care Teamsprovides the practical information, skills, and clinical approachesneeded to implement an integrated collaborative care program andsupport the members of the care team as they learn this new,evidence-based, legislatively mandated care delivery system. Uniquein presenting information specifically designed to be used in anintegrated, collaborative care workflow, this book providesspecific guidance for each member of the team. Care managers,consulting psychiatrists, primary care providers, andadministrators alike can finally get on the same page in regard topatient care by referring to the same resource and employing acommon framework. Written by recognized experts with broadresearch, clinical, implementation, and training experience, thisbook provides a complete solution to the problem of fragmentedcare. Escalating costs and federal legislation expanding access tohealthcare are forcing the industry to transition to a new model ofhealth care delivery. This book provides guidance on navigating thechanges as a team to provide the best possible patient care. Integrate physical and behavioral care Use evidence-based treatments for both Exploit leading-edge technology for patient management Support each member of the collaborative care team Strong evidence has demonstrated the efficacy of a collaborativecare approach for delivering mental health care to patients in aprimary care setting. The field is rapidly growing, but fewresources are available and working models are limited. This bookprovides a roadmap for transitioning from traditional methods ofhealth care to the new integrated model. Providers ready to move tothe next level of care will find Creating Effective Mental andPrimary Health Care Teams an invaluable resource.
From a public health perspective, alcohol is a major contributor to morbidity and mortality, and impacts on many aspects of social life. This text describes advances in alcohol research with direct relevance to the development of effective policies at local, national and international level.
Alcohol use disorder (AUD) is a major public health problem in the United States. The estimated 12-month and lifetime prevalence values for AUD are 13.9% and 29.1%, respectively, with approximately half of individuals with lifetime AUD having a severe disorder. AUD and its sequelae also account for significant excess mortality and cost the United States more than $200 billion annually. Despite its high prevalence and numerous negative consequences, AUD remains undertreated. In fact, fewer than 1 in 10 individuals in the United States with a 12-month diagnosis of AUD receive any treatment. Nevertheless, effective and evidence-based interventions are available, and treatment is associated with reductions in the risk of relapse and AUD-associated mortality. The American Psychiatric Association Practice Guideline for the Pharmacological Treatment of Patients With Alcohol Use Disorder seeks to reduce these substantial psychosocial and public health consequences of AUD for millions of affected individuals. The guideline focuses specifically on evidence-based pharmacological treatments for AUD in outpatient settings and includes additional information on assessment and treatment planning, which are an integral part of using pharmacotherapy to treat AUD. In addition to reviewing the available evidence on the use of AUD pharmacotherapy, the guideline offers clear, concise, and actionable recommendation statements, each of which is given a rating that reflects the level of confidence that potential benefits of an intervention outweigh potential harms. The guideline provides guidance on implementing these recommendations into clinical practice, with the goal of improving quality of care and treatment outcomes of AUD.
