Harnessing Collaborative Care to Meet Mental Health Demands in the Era of COVID-19

Carlo, Andrew D.; Barnett, Brian S.; Unützer, Jürgen

doi:10.1001/jamapsychiatry.2020.3216

Cited by 20 publications

(20 citation statements)

References 8 publications

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Section: Discussionmentioning

confidence: 99%

“… 26 In addition, integrated behavioral and primary care models have shown to be effective in delivery of high-quality mental health care and in treating physical and mental health problems in primary care settings, particularly during the COVID-19 crisis. 25 …”

Section: Discussionmentioning

confidence: 99%

“…24 In contrast with mental health specialists who practice mostly in urban areas, primary care physicians practice in urban and rural areas, are more likely to take all types of insurance, 24 are the major providers of care in safety-net settings and see patients of all ages, making them the first contact for patients in all demographics with mental illness. 25 In addition to being accessible, visiting a primary care physician may carry less stigma for many patients. 26 Many primary care physicians have a relationship with a patient before the onset of their mental illness, which allows for quicker recognition of the disease process.…”

Section: Discussionmentioning

confidence: 99%

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Assessing Primary Care Contributions to Behavioral Health: A Cross-sectional Study Using Medical Expenditure Panel Survey

Jetty

Petterson

Westfall

et al. 2021

J Prim Care Community Health

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Objectives To assess primary care contributions to behavioral health in addressing unmet mental healthcare needs due to the COVID-19 pandemic. Methods Secondary data analysis of 2016 to 2018 Medical Expenditure Panel Survey of non-institutionalized US adults. We performed bivariate analysis to estimate the number and percentage of office-based visits and prescription medications for depression and anxiety disorders, any mental illness (AMI), and severe mental illness (AMI) by physician specialty (primary care, psychiatry, and subspecialty) and medical complexity. We ran summary statistics to compare the differences in sociodemographic factors between patients with AMI by seeing a primary care physician versus those seeing a psychiatrist. Binary logistic regression models were estimated to examine the likelihood of having a primary care visit versus psychiatrist visit for a given mental illness. Results There were 394 023 office-based visits in the analysis sample. AMI patients seeing primary care physician were thrice as likely to report 1 or more chronic conditions compared to those seeing psychiatrist. Among patients with a diagnosis of depression or anxiety and AMI the proportion of primary care visits ([38% vs 32%, P < .001], [39% vs 34%, P < .001] respectively), and prescriptions ([50% vs 40%, P < .001], [47% vs 44%, P < .05] respectively) were higher compared to those for psychiatric care. Patients diagnosed with SMI had a more significant percentage of prescriptions and visits to a psychiatrist than primary care physicians. Conclusion Primary care physicians provided most of the care for depression, anxiety, and AMI. Almost a third of the care for SMI and a quarter of the SMI prescriptions occurred in primary care settings. Our study underscores the importance of supporting access to primary care given primary care physicians’ critical role in combating the COVID-19 related rise in mental health burden.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Assessing Primary Care Contributions to Behavioral Health: A Cross-sectional Study Using Medical Expenditure Panel Survey

Jetty

Petterson

Westfall

et al. 2021

J Prim Care Community Health

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“…The demand and need for youth mental health care continues to increase, which puts pressure on an under resourced system, and impacts the overall quality of care a young person receives (33). Innovations to the way services assess, treat and monitor youth mental health problems are critical to improve service efficiencies and clinical outcomes.…”

Section: Discussion and Future Directionsmentioning

confidence: 99%

Right Care, First Time: Developing a Theory-Based Automated Protocol to Help Clinically Stage Young People Based on Severity and Persistence of Mental Illness

Iorfino

Cheng

Cross

et al. 2021

Front. Public Health

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Most mental disorders emerge before the age of 25 years and, if left untreated, have the potential to lead to considerable lifetime burden of disease. Many services struggle to manage high demand and have difficulty matching individuals to timely interventions due to the heterogeneity of disorders. The technological implementation of clinical staging for youth mental health may assist the early detection and treatment of mental disorders. We describe the development of a theory-based automated protocol to facilitate the initial clinical staging process, its intended use, and strategies for protocol validation and refinement. The automated clinical staging protocol leverages the clinical validation and evidence base of the staging model to improve its standardization, scalability, and utility by deploying it using Health Information Technologies (HIT). Its use has the potential to enhance clinical decision-making and transform existing care pathways, but further validation and evaluation of the tool in real-world settings is needed.

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“…As the present public care service for senior citizens is biased towards physical health, the service partially addresses the concept of health, which encompasses physical, mental, and social aspects [ 12 ]. Therefore, with the present public care service, there could be unmet demands for mental health services [ 13 ]. The social health service also needs to be addressed as a public care service considering the fact that older adults perceive being connected with others as a component of health [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

Impact of Social Network Size and Contact Frequency on Resilience in Community-Dwelling Healthy Older Adults Living Alone in the Republic of Korea

Park

Kim

Eom

2021

IJERPH

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The aim of this study was to investigate the characteristics of social health and its association with resilience among older adults living alone excluded from the public care service due to their relatively good health. For this cross-sectional study, we surveyed older adults aged between 65 and 80 years using questionnaires to measure the social health status and levels of resilience of the participants. We conducted a hierarchical regression analysis to confirm the association between resilience and social network. Finally, data from 266 community-dwelling older adults were analyzed. We discovered that participants had social networks with a mean score on the Lubben Social Network Scale 18.13 ± 7.98, which means they were socially isolated. The network size (standardized β = −0.149, p < 0.05) and contact frequency (standardized β = 0.136, p < 0.05) correlated positively with higher levels of resilience. A hierarchical model accounted for 48.0% of the variance in resilience. The results suggested that interventions by the public health service to protect social health are needed for older adults living alone even when they are physically, emotionally, and cognitively healthy. In addition, smaller network size and higher frequency of contacts may be considered to strengthen resilience, which is a protective factor in social health.

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Harnessing Collaborative Care to Meet Mental Health Demands in the Era of COVID-19

Cited by 20 publications

References 8 publications

Assessing Primary Care Contributions to Behavioral Health: A Cross-sectional Study Using Medical Expenditure Panel Survey

Assessing Primary Care Contributions to Behavioral Health: A Cross-sectional Study Using Medical Expenditure Panel Survey

Right Care, First Time: Developing a Theory-Based Automated Protocol to Help Clinically Stage Young People Based on Severity and Persistence of Mental Illness

Impact of Social Network Size and Contact Frequency on Resilience in Community-Dwelling Healthy Older Adults Living Alone in the Republic of Korea

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