A blueprint for integrated mental health care

Chang, Trina; Ferris, Timothy G.

doi:10.1111/1475-6773.13593

Cited by 3 publications

(3 citation statements)

References 8 publications

(12 reference statements)

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“…Driving change in mental health systems poses challenges due to structural stigma, which creates barriers impeding policy advancements, decreasing public demand for necessary actions, and limiting policymakers’ awareness of viable policy alternatives [ 119 ]. There is a disproportionate allocation of resources in comparison to the epidemiological, economic, and social burdens posed by mental health issues, leading to caps on benefits and lower reimbursement rates [ 120 ]. This is compounded by limited governmental expenditure, typically falling below 2% of the global median of health expenditure, allowing the persistence of structural issues in mental health care financing [ 121 ].…”

Section: Discussionmentioning

confidence: 99%

Barriers and facilitators to the implementation of digital technologies in mental health systems: a qualitative systematic review to inform a policy framework

Berardi,

Antonini,

Jordan

et al. 2024

BMC Health Serv Res

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Background Despite the potential for improved population mental health and wellbeing, the integration of mental health digital interventions has been difficult to achieve. In this qualitative systematic review, we aimed to identify barriers and facilitators to the implementation of digital technologies in mental healthcare systems, and map these to an implementation framework to inform policy development. Methods We searched Medline, Embase, Scopus, PsycInfo, Web of Science, and Google Scholar for primary research articles published between January 2010 and 2022. Studies were considered eligible if they reported barriers and/or facilitators to the integration of any digital mental healthcare technologies. Data were extracted using EPPI-Reviewer Web and analysed thematically via inductive and deductive cycles. Results Of 12,525 references identified initially, 81 studies were included in the final analysis. Barriers and facilitators were grouped within an implementation (evidence-practice gap) framework across six domains, organised by four levels of mental healthcare systems. Broadly, implementation was hindered by the perception of digital technologies as impersonal tools that add additional burden of care onto both providers and patients, and change relational power asymmetries; an absence of resources; and regulatory complexities that impede access to universal coverage. Facilitators included person-cantered approaches that consider patients’ intersectional features e.g., gender, class, disability, illness severity; evidence-based training for providers; collaboration among colleagues; appropriate investment in human and financial resources; and policy reforms that tackle universal access to digital health. Conclusion It is important to consider the complex and interrelated nature of barriers across different domains and levels of the mental health system. To facilitate the equitable, sustainable, and long-term digital transition of mental health systems, policymakers should consider a systemic approach to collaboration between public and private sectors to inform evidence-based planning and strengthen mental health systems. Protocol registration The protocol is registered on PROSPERO, CRD42021276838.

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Section: Discussionmentioning

confidence: 99%

Barriers and facilitators to the implementation of digital technologies in mental health systems: a qualitative systematic review to inform a policy framework

Berardi,

Antonini,

Jordan

et al. 2024

BMC Health Serv Res

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“…This approach is designed to deliver comprehensive and personalized healthcare services, encompassing health education, prevention, therapeutic intervention, rehabilitation, and palliative care (4). These services were integrated to meet the diverse health requirements of different resident groups and facilitate coordination among healthcare institutions at all levels to offer a seamless, lifelong continuum of care (5).…”

Section: Introductionmentioning

confidence: 99%

Study on the evaluation and influencing factors of contracted residents on the coordination of primary medical institutions

Xu,

Jiang

et al. 2024

Front. Public Health

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BackgroundThe implementation of family doctor contract service is a pivotal measure to enhance primary medical services and execute the hierarchical diagnosis and treatment system. Achieving service coordination among various institutions is both a fundamental objective and a central element of contract services.ObjectiveThe study aims to assess residents’ evaluations and determining factors related to the coordination of health services within primary medical institutions across different regions of Shandong Province. The findings intend to serve as a reference for enhancing the coordination services offered by these institutions.MethodsThe study employed a multi-stage stratified random sampling method to select three prefecture-level cities in Shandong Province with different economic levels. Within each city, three counties (districts) were randomly sampled using the same method. Within each county (district), three community health service centers and township health centers implementing family doctor contract services were selected randomly. Face-to-face questionnaire surveys were conducted with contracted residents using the coordination dimension of the revised Primary Care Assessment Tools Scale (PCAT) developed by the research team. Data analysis was conducted using such methods as one-way analysis of variance and multiple linear regression.ResultsThe sample included 3,859 contracted residents. The coordination dimension score of primary medical institutions averaged 3.41 ± 0.18, with the referral service sub-dimension scoring 3.60 ± 0.58 and the information system sub-dimension scoring 3.34 ± 0.65. The overall score of the referral service sub-dimension surpassed that of the information system sub-dimension. Regression results indicated that the city’s economic status, the type of contracted institutions, gender, education, marital status, income, occupation, health status, and endowment insurance payment status significantly influenced the coordinated service score of primary medical institutions (p < 0.05).ConclusionThe coordination of primary medical institutions in Shandong Province warrants further optimization. Continued efforts should focus on refining the referral system, expediting information infrastructure development, enhancing the service standards of primary medical institutions, and fostering resident trust. These measures aim to advance the implementation of the hierarchical diagnosis and treatment and two-way referral system.

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Section: Introductionmentioning

confidence: 99%

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A blueprint for integrated mental health care

Cited by 3 publications

References 8 publications

Barriers and facilitators to the implementation of digital technologies in mental health systems: a qualitative systematic review to inform a policy framework

Barriers and facilitators to the implementation of digital technologies in mental health systems: a qualitative systematic review to inform a policy framework

Study on the evaluation and influencing factors of contracted residents on the coordination of primary medical institutions

Table_3.docx

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