Consultation liaison in primary care for people with mental disorders

Gillies, Donna; Buykx, Penny; Parker, Alexandra G.; Hetrick, Sarah

doi:10.1002/14651858.cd007193.pub2

Cited by 61 publications

(60 citation statements)

References 85 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Shared-care was also promoted by hiring respondent-psychiatrists (3 h per months per 50 000 inhabitants) to provide consultation and support to HSSC-MH primary care teams and GPs [ 17 ]. According to a meta-analysis, shared-care improves the capacity of GPs to prescribe pharmacological therapy and to provide adequate treatment [ 32 ]. Individuals with common MHD, particularly depression, experienced greater satisfaction and adherence to treatment [ 32 , 33 ]; whereas the effectiveness of shared-care has yet to be demonstrated for severe and co-occurring MHD-SUD.…”

Section: Introductionmentioning

confidence: 99%

Implementation of the Quebec mental health reform (2005–2015)

Fleury

Grenier

Vallée

et al. 2016

BMC Health Serv Res

View full text Add to dashboard Cite

BackgroundThis study evaluates implementation of the Quebec Mental Health (MH) Reform (2005–2015) which aimed to improve accessibility, quality and continuity of care by developing primary care and optimizing integrated service networks. Implementation of MH primary care teams, clinical strategies for consolidating primary care, integration strategies to improve collaboration between primary care and specialized services, and facilitators and barriers related to these measures were examined.MethodsEleven Quebec MH service networks provided the study setting. Networks were identified in consultation with 20 key MH decision makers and selected based on variation in services offered, integration strategies, best practices, and geographic criteria. Data collection included: primary documents, structured questionnaires completed by 25 managers from MH primary care teams and 16 respondent-psychiatrists working in shared-care, and semi-structured interviews with 102 network stakeholders involved in the reform. The study employed a mixed method approach, triangulating the three data sources across networks.ResultsWhile implementation was not fully achieved in most networks, the Quebec reform succeeded in improving primary care services with the creation of adult primary care teams, and one-stop services which increased access to care, mainly for clients with common MH disorders. In terms of clinical strategies implemented, the functions provided by respondent-psychiatrists had a greater impact on the MH primary care teams than on general practitioners (GPs) in medical clinics; whereas the implementation of best practices were indirect outcomes of another reform developed simultaneously by the Quebec substance use disorders program. The main integration strategies used for increasing continuity of care and collaboration between primary care and specialized services were those involving fewer formal procedures such as referrals between teams and organizations. The lack of operational mechanisms and protocols governing new services and structures were important barriers to primary care consolidation and service integration, as was the lack of interest and involvement of most GPs in MH.ConclusionsSuccessful and sustained healthcare reform requires attention to process and outcomes as well as structural change or service reorganization. Six recommendations for more successful implementation of the Quebec MH Reform are provided, with implications for healthcare reform internationally.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-016-1832-5) contains supplementary material, which is available to authorized users.

show abstract

Section: Introductionmentioning

confidence: 99%

Implementation of the Quebec mental health reform (2005–2015)

Fleury

Grenier

Vallée

et al. 2016

BMC Health Serv Res

View full text Add to dashboard Cite

show abstract

“…Psychiatric consultation liaison services in primary healthcare improve mental health for up to 3 months and satisfaction and adherence for up to 12 months in persons with mental illness. This effect is particularly strong for persons with depression [10]. Additionally, proactive consultation liaison psychiatry (i.e., psychiatrists working in medical or surgical hospital settings or multidisciplinary team-based models) with clinically informed screening and integrated care delivery reduce length of stay in general hospital settings We computed a score for AMSTAR 2 by scoring all items whose criteria were fully fulfilled by a study as "1" and all other items as "0" and by transforming the raw scores into percentage of maximum possible scores (POMP scores [18]).…”

Section: Crisis Intervention Servicesmentioning

confidence: 98%

“…Care coordination across different settings involves the collaboration of various care providers and patients, for example, between mental health specialists and other care providers. Consultation liaison psychiatry, for example, has a strong history in hospital-based care but is becoming increasingly important in primary care settings [10].…”

Section: Care Coordination: Models and Conceptsmentioning

confidence: 99%

EPA guidance on the quality of mental health services: A systematic meta-review and update of recommendations focusing on care coordination

et al. 2020

View full text Add to dashboard Cite

Background. The quality of mental health services is crucial for the effectiveness and efficiency of mental healthcare systems, symptom reduction, and quality of life improvements in persons with mental illness. In recent years, particularly care coordination (i.e., the integration of care across different providers and treatment settings) has received increased attention and has been put into practice. Thus, we focused on care coordination in this update of a previous European Psychiatric Association (EPA) guidance on the quality of mental health services. Methods. We conducted a systematic meta-review of systematic reviews, meta-analyses, and evidence-based clinical guidelines focusing on care coordination for persons with mental illness in three literature databases. Results. We identified 23 relevant documents covering the following topics: case management, integrated care, home treatment, crisis intervention services, transition from inpatient to outpatient care and vice versa, integrating general and mental healthcare, technology in care coordination and self-management, quality indicators, and economic evaluation. Based on the available evidence, we developed 15 recommendations for care coordination in European mental healthcare. Conclusions. Although evidence is limited, some concepts of care coordination seem to improve the effectiveness and efficiency of mental health services and outcomes on patient level. Further evidence is needed to better understand the advantages and disadvantages of different care coordination models.

show abstract

“…Hier arbeiten Allgemeinmediziner und Fachpsychotherapeuten gleichberechtigt und störungsunspezifisch mit denselben Patienten. Die Studienlage hierzu gilt aktuell als begrenzt, insbesondere was die direkte gemeinsame Versorgung betrifft [9]. Im stationären Bereich hat sich das Konsil-/ Liaison-Modell als interdisziplinäres Versorgungskonzept erfolgreich etabliert [10].…”

Section: Modelle Der Psychosomatischen Versorgung In Hausarztpraxenunclassified

Psychosomatische Sprechstunde in der Hausarztpraxis – ein neues Kooperationsmodell von Psychosomatik und Allgemeinmedizin

Hartmann

Finkenzeller

Boehlen

et al. 2018

Psychother Psych Med

View full text Add to dashboard Cite

ZusammenfassungEine hohe Zahl an Patienten mit psychischen oder psychosomatischen Erkrankungen erhält derzeit keine adäquate fachärztliche bzw. fachpsychotherapeutische Behandlung, sondern verbleibt diesbezüglich alleinig beim Hausarzt. Ursachen sind häufig lange Wartezeiten auf Psychotherapie, patientenseitige Barrieren oder offene differenzialdiagnostische Fragen. Daher entwickelten wir ein Versorgungskonzept, das direkt in der Hausarztpraxis ansetzt und offen für jegliche psychosomatische Störung ist. Dieses Modell, das im Kern eine vor-Ort Sprechstunde durch einen Facharzt für Psychosomatische Medizin umfasst, wird im Folgenden vorgestellt. Erste Erfahrungen bezüglich Inanspruchnahme und Patientenklientel belegen eine hohe Akzeptanz seitens Patienten, Hausärzten und Fachärzten für Psychosomatische Medizin.

show abstract

Consultation liaison in primary care for people with mental disorders

Cited by 61 publications

References 85 publications

Implementation of the Quebec mental health reform (2005–2015)

Implementation of the Quebec mental health reform (2005–2015)

EPA guidance on the quality of mental health services: A systematic meta-review and update of recommendations focusing on care coordination

Psychosomatische Sprechstunde in der Hausarztpraxis – ein neues Kooperationsmodell von Psychosomatik und Allgemeinmedizin

Contact Info

Product

Resources

About