Proximity of providers: Colocating behavioral health and primary care and the prospects for an integrated workforce.

Miller, Benjamin F.; Petterson, Stephen; Burke, Bridget Teevan; Phillips, Robert L.; Green, Larry A.

doi:10.1037/a0036093

Cited by 54 publications

(39 citation statements)

References 33 publications

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“…6,8 To date, there have been limited attempts to assess where integration is occurring throughout the country. 9 The challenge for this assessment is the vast differences in practices' classification schemas for integration and the lack of a national database that clearly encapsulates the practices that are integrating primary care and behavioral health on site. 10,11 This article uses a novel approach to identify where behavioral health and primary care service delivery currently intersect and diverge, focusing on their proximity or colocation to each other.…”

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confidence: 99%

Primary Care, Behavioral Health, Provider Colocation, and Rurality

Miller

Petterson

Levey

et al. 2014

The Journal of the American Board of Family Medicine

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Purpose: The purpose of this study was to characterize the proximity of primary care and behavioral health service delivery sites in the United States and factors influencing their colocation.Methods: We geocoded the practice addresses of primary care and behavioral health providers found in the Centers for Medicare & Medicaid Services' National Plan and Provider Enumeration System Downloadable File to report where colocation is occurring throughout the country.Results: The extent to which primary care physicians are colocated with behavioral health providers is strongly associated with rurality. Specifically, 40.2% of primary care physicians in urban areas are colocated with behavioral health providers compared with 22.8% in isolated rural areas and 26.5% in frontier areas. However, when controlling for number of primary care physicians at a location, the odds of colocation actually are greater for physicians in a frontier area than those in urban areas (odds ratio, 1.289; P < .01).Conclusions :

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confidence: 99%

Primary Care, Behavioral Health, Provider Colocation, and Rurality

Miller

Petterson

Levey

et al. 2014

The Journal of the American Board of Family Medicine

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“…3,20 For practices that are not yet ready to take these steps or are not supported by an appropriate reimbursement system, the initial steps to coordinate or colocate behavioral health can serve as progressive steppingstones. [21][22][23] Although the evidence base for the coordinated approach is limited, screening patients for behavioral health problems and providing brief interventions in consultation with remote behavioral health specialists has the potential to improve behavioral health care. 24 Coordination may be an attractive first step toward integration, although reimbursement for telehealth services remains a barrier, and the approach requires primary care clinicians to develop strong relationships with behavioral health specialists.…”

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confidence: 99%

The Medical Home and Integrated Behavioral Health: Advancing the Policy Agenda

et al. 2015

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There has been a considerable expansion of the patient-centered medical home model of primary care delivery, in an effort to reduce health care costs and to improve patient experience and population health. To attain these goals, it is essential to integrate behavioral health services into the patientcentered medical home, because behavioral health problems often first present in the primary care setting, and they significantly affect physical health. At the 2013 Patient-Centered Medical Home Research Conference, an expert workgroup convened to determine policy recommendations to promote the integration of primary care and behavioral health. In this article we present these recommendations: Build demonstration projects to test existing approaches of integration, develop interdisciplinary training programs to support members of the integrated care team, implement population-based strategies to improve behavioral health, eliminate behavioral health carve-outs and test innovative payment models, and develop population-based measures to evaluate integration.

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“…Such programs have been demonstrated to be effective in the provision of high quality health care and mental health services provided at no cost to youth and families and have been shown to be effective at ameliorating psychological distress among rural adolescents (Albright et al, 2013). Similarly, medical homes with care coordination and community health clinics that colocate mental health services represent promising approaches for improving access and availability to behavioral health services in rural areas (Miller, Petterson, Burke, Phillips, & Green, 2014). The data from the present study suggest that clinicians in these settings should be aware of the potential consequences of short weekday sleep duration.…”

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confidence: 99%

Sleep duration, mental health, and substance use among rural adolescents: Developmental correlates.

Jameson¹,

Michael²

2015

Journal of Rural Mental Health

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Numerous studies have demonstrated that most adolescents do not get adequate amounts of sleep. Furthermore, insufficient sleep is associated with increased risk for depression and suicide attempts as well as substance abuse in adolescence. However, extant studies have relied primarily on national samples or suburban adolescents, with a paucity of research examining the associations between sleep duration and mental health and substance abuse risk in rural adolescents. Additionally, these associations rarely have been examined within a developmental context. The present study attempted to address these gaps by using data from the Youth Risk Behavior Survey (YRBS) to examine the associations between sleep duration and risk factors in the lower and upper grade levels for high school students attending schools in rural areas. YRBS data were obtained from 2 rural school districts located in the Appalachian region of North Carolina (n ϭ 987). For the full sample, approximately 40% of students reported receiving 6 or fewer hours of sleep on a typical school night. High school students in the lower grades (9th and 10th) who reported short sleep duration were more likely to have endorsed each of the mental health, suicidal behavior, and substance use items. Significant differences emerged between sleep groups on suicide attempts and alcohol, tobacco, and marijuana use for students in the upper grade levels. We conclude that short sleep duration is problematic in rural high school students, especially for those students recently transitioning from middle school to high school. These findings can inform identification, prevention, and intervention strategies to encourage and promote healthy sleep habits among rural adolescents.

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Proximity of providers: Colocating behavioral health and primary care and the prospects for an integrated workforce.

Cited by 54 publications

References 33 publications

Primary Care, Behavioral Health, Provider Colocation, and Rurality

Primary Care, Behavioral Health, Provider Colocation, and Rurality

The Medical Home and Integrated Behavioral Health: Advancing the Policy Agenda

Sleep duration, mental health, and substance use among rural adolescents: Developmental correlates.

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