Bringing together treatment and referral advice from existing guidelines, this text aims to improve access to services and recognition of common mental health disorders in adults and provide advice on the principles that need to be adopted to develop appropriate referral and local care pathways.
Ask for a definition of primary care, and you are likely to hear as many answers as there are health care professionals in your survey. Primary Care fills this gap with a detailed definition already adopted by professional organizations and praised at recent conferences. This volume makes recommendations for improving primary care, building its organization, financing, infrastructure, and knowledge baseâ€"as well as developing a way of thinking and acting for primary care clinicians. Are there enough primary care doctors? Are they merely gatekeepers? Is the traditional relationship between patient and doctor outmoded? The committee draws conclusions about these and other controversies in a comprehensive and up-to-date discussion that covers: The scope of primary care. Its philosophical underpinnings. Its value to the patient and the community. Its impact on cost, access, and quality. This volume discusses the needs of special populations, the role of the capitation method of payment, and more. Recommendations are offered for achieving a more multidisciplinary education for primary care clinicians. Research priorities are identified. Primary Care provides a forward-thinking view of primary care as it should be practiced in the new integrated health care delivery systemsâ€"important to health care clinicians and those who train and employ them, policymakers at all levels, health care managers, payers, and interested individuals.
This manual attempts to provide simple, adequate and evidence-based information to health care professionals in primary health care especially in low- and middle-income countries to be able to provide pharmacological treatment to persons with mental disorders. The manual contains basic principles of prescribing followed by chapters on medicines used in psychotic disorders; depressive disorders; bipolar disorders; generalized anxiety and sleep disorders; obsessive compulsive disorders and panic attacks; and alcohol and opioid dependence. The annexes provide information on evidence retrieval, assessment and synthesis and the peer view process.
The purpose of this book is to provide a children’s mental health resource tailored to the needs of physicians working with children. There are currently no such texts, despite the fact that there are patient care, healthcare systems, and workforce factors that indicate a strong need for such a resource. Approximately 1 in 5 children are diagnosed with a mental illness by the age of 18. Additionally, mental health conditions, including Attention Deficit Hyperactivity Disorder, are consistently among the most common chronic conditions in pediatric clinical populations. Delays in both diagnosis and treatment increase the morbidity associated with these conditions. These delays expose the child to negative ramifications of his/her illness and can impact rates of poor academic performance, substance use disorders and criminal justice system involvement – potentially impacting long-term life trajectories. Early identification of mental illness and appropriate intervention is critical to the healthy development of youth, though physicians in primary care and pediatrics are seldom trained to detect and treat such illnesses. The importance of recognizing mental illness is reflected in practice guidelines for pediatric primary care providers as well as in how service delivery is being structured, but this does not offer in-depth clinical guidelines. Additionally, integrated care and medical home models include mental health as key components, though yet again physicians are often not trained to work with these models. While clearly indicated clinically, these requirements do not come with significant increases in reimbursement and are added to an already demanding schedule. Increasingly, providers are also expected to use evidence based screening instruments without exposure to this body of literature. Some guidance on using those instruments in context will help them to use those tools more effectively. Finally, primary care providers and even some adult psychiatrists and psychologists are operating in a healthcare system with a severe, nationwide shortage of child and adolescent psychiatrists and mental healthcare providers. While a text certainly cannot single-handedly compensate for such a workforce shortage, it could potentially help to mitigate the negative impact on patients by facilitating early identification and treatment in the primary care setting. Additionally, with more effective treatment in pediatric settings, less complex cases may be addressed before specialty care is needed, and the expertise of child and adolescent psychiatrists can be more effectively used for more complex cases. Pediatric Psychiatry in Primary Care is the ultimate resource for clinicians working with children, including pediatricians, family physicians, general psychiatrists, psychologists, early career child psychiatrists, social workers, nurses, school counselors, and all clinical professionals who may encounter children struggling with psychiatric disorders.
This timely and important work looks at the collaborative health care model for the delivery of mental health care in a primary care setting. This has become the ideal model for the treatment of comorbid medical and psychiatric or psychological disorders. There is also an increased awareness that pharmacological intervention, the most frequently delivered intervention for psychological disorders, is often of limited effectiveness without concurrent specific psychological intervention. The book includes more than two dozen case studies, co-written by clinical psychologists and primary care physicians. It is essential reading for any psychology practitioner in a clinical setting, as well as for health care administrators.
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.
Mental, neurological, and substance use disorders are common, highly disabling, and associated with significant premature mortality. The impact of these disorders on the social and economic well-being of individuals, families, and societies is large, growing, and underestimated. Despite this burden, these disorders have been systematically neglected, particularly in low- and middle-income countries, with pitifully small contributions to scaling up cost-effective prevention and treatment strategies. Systematically compiling the substantial existing knowledge to address this inequity is the central goal of this volume. This evidence-base can help policy makers in resource-constrained settings as they prioritize programs and interventions to address these disorders.
