Series Foreword -- Acknowledgments -- Introduction -- I.A Primer on Integrated Primary Care -- Chapter 1. Overview of Integrated Primary Care -- Chapter 2. Fundamentals of Primary Care Behavioral Health Integration -- Chapter 3. Conducting the Behavioral Health Consultation Appointment -- II. Common Conditions Treated in Primary Care Behavioral Health -- Chapter 4. Depression -- Chapter 5. Anxiety -- Chapter 6. Insomnia -- Chapter 7. Diabetes -- Chapter 8. Chronic Pain -- Chapter 9. Asthma -- III. Future Directions -- Chapter 10. Future Directions in Training, Funding, and Research -- References -- About the Author
In the current fast-paced healthcare environment, there is a need for more timely access to high quality behavioral health services. Integrated Psychological Services in Primary Care was developed by practicing psychologists, physicians, college professors, and licensed professional counselors who have embraced the integrated care model, and these distinguished authors share their invaluable insights and practical experiences. This book reviews different strategies for the implementation of behavioral health services in primary care, and there is also a practical discussion of common clinical presentations which can be effectively treated with collaborative care. This book reinforces the relevance of integrated psychological services to primary care settings. There is an emphasis on providing an advanced and cost-sensitive collaborative care model which most efficiently addresses the needs of our patients.
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.
Integrated care incorporates behavioral and physical health services into primary care and specialty medical environments. These models of care are patient-centered. population focused, and delivered by a multidisciplinary team of medical professionals. This book is practical, office-based, comfortably accessible, and intended for mental health professionals, primary care and medical specialists, and professional health students, residents, and other professionals working in integrated care environments.
This concise guide offers a primer for behavioral health care professionals who are new to integrated primary care systems, with a particular focus on the Primary Care Behavioral Health (PCBH) model of integrated service delivery.
The goals of Integrated Care: Working at the Interface of Primary Care and Behavioral Health are to educate psychiatrists about the fundamental shift underway in health care and to prepare them to be successful and effective in the new health care arena. The passage and implementation of the Patient Protection and Affordable Care Act presents an opportunity for newly insured patients and for funding models of integrated care, enabling psychiatrists to have a more significant population-level impact. The only book of its kind, the guide defines integrated care, reviews the evidence base, and addresses the three potential benefits of this model of care: improved outcomes, cost containment, and enhanced patient experience (also known as the "triple aim"). The new models of integrated care presented in this book are population-based, which is the key to improved outcomes, and they represent a change in how medicine in general and psychiatry in particular will approach health care delivery moving forward. The book's features are both high-impact and user-friendly: The book is divided into two sections, "Behavioral Health in Primary Care Settings" and "Primary Care in Behavioral Health Care Settings," with Section 1 focused on improving the detection and treatment of behavioral health conditions by integrating behavioral health services into primary care settings and Section 2 focused on improving the health status of patient populations with serious mental illness by integrating primary care into behavioral health treatment. Each chapter presents a set of "core principles of effective collaborative care," which serve as a guide for the structure and provision of care for the varying models, regardless of the setting. Contributors provide dozens of examples that highlight the impact psychiatrists can make in achieving the triple aim of improved outcomes, cost containment, and enhanced experience. Detailed case vignettes integrated throughout the book bring concepts to life and help clinicians to understand and improve the patient-provider relationship. The information presented in these chapters allows both practicing psychiatrists and those in training to develop a skill set essential to designing, working in, teaching, or promoting an integrated care program within a health care system. Evidence based and timely, Integrated Care: Working at the Interface of Primary Care and Behavioral Health is a must read for clinicians in the brave new world of health care reform.
This timely new edition of Integrated Behavioral Health in Primary Care brings the reader up to speed with the changing aspects of primary care service delivery in response to the Patient-Centered Medical Home (PCMH), the Triple-Aim health approach, and the Patient Protection and Affordable Care Act. Drawing on research evidence and years of experience, the authors provide practical information and guidance for behavioral health care practitioners who wish to work more effectively in the fast-paced setting of primary care, and provide detailed advice for addressing common health problems such as generalized anxiety disorder, depression, weight issues, sleep problems, cardiovascular disorders, pain disorders, sexual problems, and more. New to this edition are chapters on population health and the PCMH; children, adolescents, and parenting; couples; managing suicide risk; and shared medical appointments. This paperback edition was previously published in hardcover in 2017.
Patients with chronic conditions often need psychosocial support and brief counseling to help them make the lifestyle and behavioral changes required to prevent disease complications. This innovative text, with contributions from respected clinicians and researchers in all arenas of behavioral health, provides comprehensive training for all health professionals including those in medicine, nursing, social work, mental health, and clinical and health psychology who desire targeted evidence-based training in Behavioral Health skills . Rich case examples drawn from typical patient presentations demonstrate the relationship between physical and psychological health and the complexity of behavior change in chronic illness. This text is a timely, relevant and practical resource for all members of the primary care team. It prepares team members to work in the model of patient-centered integrated care in accordance with the recommendations of the Affordable Health Care Act (ACA) and the National Committee for Quality Assurance (NCQA) medical home standards for identifying patient needs and providing coordinated and comprehensive patient care. It focuses on knowledge and skills needed for working with the most common chronic conditions such as diabetes, obesity, chronic pain, cardiovascular conditions, sleep disorders, geriatric conditions, cancer-related conditions, and substance abuse. It includes chapters on epidemiological trends in chronic illness and systems medicine. Theories of health behavior and behavior change and evidence-based interventions provide a foundation for skill development, followed by detailed coverage of the requirements for behavioral management of specific chronic conditions. Sample referrals and consultation notes provide concrete examples of how the behavioral health specialist might respond to a referral. . Key Features: Provides comprehensive graduate-level training for the role of Behavioral Health Specialist Describes the health promotion and counseling skills needed to function as part of an integrated health team Focuses on proficiencies needed for working with common chronic conditions Addresses the psychosocial components of primary care disorders Includes case examples demonstrating the relationship between physical and psychological health and the complexity of behavior change in chronic illness
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.
Contributed by experts who’ve developed integrative healthcare initiatives with strengths in the areas of policy and principles, organizational systems, or clinical practice. These contributors will illustrate the concepts and describe the nuts and bolts of their integration initiatives. In the conclusion of each section, the editors will construct a template to systematically evaluate these essential elements. This template will organize the information to help stakeholders compare and contrast the strengths, resources, limitations and challenges of how each model meets the vision of integrative healthcare. In the concluding section the information in the preceding sections connects to provide a coherent synopsis of the common themes and practices, from the macro to micro levels of care, which foster successful integration of the medical and psychosocial systems.
