Collaborative and Integrated Care for Adolescent Depression

Kodish, Ian; Richardson, Laura P.; Schlesinger, Abigail

doi:10.1016/j.chc.2019.02.003

Cited by 12 publications

(21 citation statements)

References 37 publications

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“…Only 4 participants did not attend any sessions. Previous studies have shown that integrating behavioral health services into primary care is feasible and effective for treating depressed youth as compared to providing usual care (Kodish et al, 2019;Richardson et al, 2014); however, collaborative care models primarily focus on providing traditional forms of treatment (e.g., psychotherapy or psychiatric medication) rather than holistic approaches. Thus, the current study extends the current collaborative care model by the integration of a holistic treatment approach in a collaborative care setting.…”

Section: Acceptability Of Mbsgs In Primary Carementioning

confidence: 99%

“…(Collins et al, 2010) Moreover, providing behavioral health treatment in primary care allows for improved communication between medical and behavioral health staff regarding co-occurring health problems and medication management. (Asarnow, Rozenman, Wiblin, & Zeltzer, 2015;Crowley & Kirschner, 2015) Integrating behavioral health services like depression screening, psychotherapy, and prescription medication is encouraged by professional agencies such as the American Academy of Pediatrics (A. H. Cheung et al, 2007;Amy H. Cheung, Zuckerbrot, Jensen, Laraque, & Stein, 2018), and collaborative care models have shown to be associated with improved health outcomes; (Kodish, Richardson, & Schlesinger, 2019) however, research indicates that a substantial amount of youth do not utilize treatment services. (O'Connor et al, 2016) Thus, innovative programming for adolescent depression treatment in primary care is needed.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Mind-Body Skills Groups for Adolescents With Depression in Primary Care: A Pilot Study

Aalsma¹,

Jones²,

Staples³

et al. 2020

Journal of Pediatric Health Care

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Section: Acceptability Of Mbsgs In Primary Carementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Mind-Body Skills Groups for Adolescents With Depression in Primary Care: A Pilot Study

Aalsma¹,

Jones²,

Staples³

et al. 2020

Journal of Pediatric Health Care

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“…However, depression diagnosis and treatment are inadequate among pediatric populations as the limited numbers of specialists makes it challenging to access care [64,65]. Primary care is an ideal setting to manage pediatric depression as this population is cared for by a family medicine or pediatric team, allowing for routine assessments and greater opportunity for intervention [66].…”

Section: Special Considerations For Treating Depression In the Pcmh: mentioning

confidence: 99%

“…Multiple models of care have been proposed for treating depression in youth including co-location, coordinated care, and integrated care. While these models can increase access to and engagement with behavioral health services for pediatric populations, collaboration between providers is necessary to positively impact depression outcomes [66,67]. Improving collaboration with the limited specialty mental health providers results in improved depression care despite personnel shortages.…”

Section: Special Considerations For Treating Depression In the Pcmh: mentioning

confidence: 99%

The Role of the Patient-Centered Medical Home in Treating Depression

Bogucki

Williams

Solberg

et al. 2020

Curr Psychiatry Rep

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Purpose of Review This review discusses the role of the patient-centered medical home (PCMH) in treating depression, focusing on findings from primary care-based studies and their implications for the PCMH. Recent Findings Pharmacotherapy, psychotherapy, and collaborative care are evidence-based treatments for depression that can be delivered in primary care and extended to diverse populations. Recent research aligns with the core components of the PCMH model. Summary The core components of the PCMH are critical elements of depression treatment. Comprehensive care within the PCMH addresses medical and behavioral health concerns, including depression. Psychiatric and psychological care must be flexibly delivered so services remain accessible yet patient-centered. To ensure the quality and safety of treatment, depression symptoms must be consistently monitored. Coordination within and occasionally outside of the PCMH is needed to ensure patients receive the appropriate level of care. More research is needed to empirically evaluate depression treatment within the PCMH.

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“…Qualitative studies have assessed barriers and facilitators in implementing integrated MH services into primary care around multiple issues. At the systemlevel these included supportive legislative/policy environment [25,54], availability of appropriate resources [55], preexisting relationships between specialized MH services and primary care [22,56], and adequate incentives [25,[57][58][59]. Organizational-level issues included clinician acceptance of the model [60,61], team stability [55], organizational support [1,62,63], leadership [55,62], and feedback on model effectiveness [59].…”

Section: Introductionmentioning

confidence: 99%

Deployment of the consultation-liaison model in adult and child-adolescent psychiatry and its impact on improving mental health treatment

Grenier

Gentil

et al. 2021

BMC Fam Pract

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Background Little information exists on the perceptions of psychiatrists regarding the implementation and various impacts of the consultation-liaison model. This model has been used in Quebec (Canada) through the function of specialist respondent-psychiatrists (SRP) since 2009. This study assessed the main activities, barriers or facilitators, and impact of SRP in adult and child-adolescent psychiatry on the capacity of service providers in primary care and youth centers to treat patients with mental health disorders (MHD). Methods Data included 126 self-administered questionnaires from SRP and semi-structured interviews from 48 SRP managers. Mixed methods were used, with qualitative findings from managers complementing the SRP survey. Comparative analyses of SRP responses in adult versus child-adolescent psychiatry were also conducted. Results Psychiatrists dedicated a median 24.12 h/month to the SRP function, mainly involving case discussions with primary care teams or youth centers. They were confident about the level of support they provided and satisfied with their influence in clinical decision-making, but less satisfied with the support provided by their organizations. SRP evaluated their impacts on clinical practice as moderate, particularly among general practitioners (GP). SRP working in child-adolescent psychiatry were more comfortable, motivated, and positive about their overall performance and impact than in adult psychiatry. Organizational barriers (e.g. team instability) were most prevalent, followed by system-level factors (e.g. network size and complexity, lack of resources, model inflexibility) and individual factors (e.g. GP reluctance to treat patients with MHD). Organizational facilitators included support from family medicine group directors, collaboration with university family medicine groups and coordination by liaison nurses; at the system level, pre-existing relationships and working in the same institution; while individual-level facilitators included SRP personality and strong organizational support. Conclusion Quebec SRP were implemented sparingly in family medicine groups and youth centers, while SRP viewed their overall impact as moderate. Results were more positive in child-adolescent psychiatry than in adult psychiatry. Increased support for the SRP function, adapting the model to GP in need of more direct support, and resolving key system issues may improve SRP effectiveness in terms of team stability, coordination among providers, access to MH services and readiness to implement innovations.

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Collaborative and Integrated Care for Adolescent Depression

Cited by 12 publications

References 37 publications

Mind-Body Skills Groups for Adolescents With Depression in Primary Care: A Pilot Study

Mind-Body Skills Groups for Adolescents With Depression in Primary Care: A Pilot Study

The Role of the Patient-Centered Medical Home in Treating Depression

Deployment of the consultation-liaison model in adult and child-adolescent psychiatry and its impact on improving mental health treatment

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