Reducing the Impacts of Mental Health Stigma Through Integrated Primary Care: An Examination of the Evidence

Rowan, Anderson B.; Grove, Jessica; Solfelt, Lindsay

doi:10.1007/s10880-020-09742-4

Cited by 8 publications

(6 citation statements)

References 77 publications

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“…This finding underscores the potential importance of anti-stigma campaigns, integrated behavioral health treatment and other interventions in general medical settings and continued expansion of tele-health treatment, all of which reduce stigma-related barriers to mental health and substance use treatment. 38 , 39 Further, almost half of individuals with OUD who did not receive mental health care between 2009 and 2020 identified high cost of mental health care as the biggest barrier to accessing treatment, and this is consistent with a recent study. 40 This is of particular concern given that our data contained information about post-implementation of the Affordable Care Act and demonstrate the importance of continued efforts to reduce cost barriers, including enforcement of mental health and addiction parity, expansion of certified community behavioral health clinics, Medicaid expansion, and efforts to address behavioral health workforce shortages.…”

Section: Discussionsupporting

confidence: 86%

National trends of suicidal ideation and mental health services use among US adults with opioid use disorder, 2009–2020

Bommersbach

Petrakis

et al. 2022

eClinicalMedicine

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Section: Discussionsupporting

confidence: 86%

National trends of suicidal ideation and mental health services use among US adults with opioid use disorder, 2009–2020

Bommersbach

Petrakis

et al. 2022

eClinicalMedicine

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“…Given barriers to behavioral health care among chronically trauma-exposed Black adults living in low-income communities in the United States (Alegría et al, 2016), integrating MBIs into primary care locations may both reduce stigma (Rowan et al, 2021) and increase access, because primary care clinics in safety net hospitals often serve as the only option for regular health care for individuals with limited socioeconomic resources and may enable buy in for mental health services (Farber et al, 2017; Nath et al, 2016). Evidence supports the value of MBIs in primary care settings, including with individuals with symptoms of both PTSD and MDD (Possemato et al, 2016).…”

mentioning

confidence: 99%

Primary care-based mindfulness intervention for posttraumatic stress disorder and depression symptoms among Black adults: A pilot feasibility and acceptability randomized controlled trial.

Powers¹,

Lathan²,

Dixon³

et al. 2023

Psychological Trauma: Theory, Research, Practice, and Policy

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Objective: There is support for the use of mindfulness-based approaches with trauma-exposed adults. However, limited data are available on feasibility and acceptability of group-based mindfulness interventions in urban medical clinics serving primarily Black adults with low socioeconomic resources, where rates of trauma exposure are high. The present randomized pilot study evaluated the feasibility and acceptability of an 8-week adapted mindfulness-based cognitive therapy (MBCT) group for trauma-exposed Black adults who screened positive for posttraumatic stress disorder (PTSD) and depression in an urban primary care clinic setting. Method: Participants were randomized to waitlist control (WLC) or MBCT. Feasibility and acceptability were assessed through examination of retention rates, measures of group satisfaction and treatment barriers, and qualitative interview. Forty-two Black adults (85% women) were consented; of those, 34 (81%) completed preassessment and randomization. Results: Feasibility of study design was shown, with >75% (n = 26) of randomized participants completing the study through postassessment. Twenty-four individuals (70.5%) completed through 1-month follow-up. Results showed high levels of group acceptability across quantitative and qualitative measures. Perceived barriers to psychological treatment were high, with an average of >6 barriers present. Conclusions: The findings indicate feasibility and acceptability of MBCT group interventions in urban primary care settings with trauma-exposed patients with significant psychopathology. However, substantial barriers to treatment engagement were endorsed and to improve numbers for successful engagement in the intervention, continued efforts to reduce treatment barriers and increase access to mindfulness-based interventions in underresourced communities are needed.

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“…Families may feel that disclosing mental health concerns reveals yet another area for negative evaluation. As participants noted, presenting mental health as a normal and important part of diabetes care for all adolescents may decrease stigma 27 . If clinics provide routine mental health check‐ups for all youth with T1D, those experiencing psychosocial concerns may be less likely to feel singled out.…”

Section: Discussionmentioning

confidence: 99%

Psychosocial screening in a pediatric diabetes clinic: Adolescents' and mothers' perspectives

et al. 2022

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Objective: Adolescents with type 1 diabetes (T1D) frequently experience psychosocial concerns, and mental health screening is becoming increasingly common in routine diabetes care. However, little is known about what adolescents or their caregivers think about the role of mental health screening and intervention within the context of comprehensive diabetes care, or how their diabetes care providers should be involved in navigating mental health concerns. This study used qualitative methods to obtain the perspectives of adolescents with T1D and their caregivers regarding these issues.Methods: Participants were 13 adolescents with T1D (ages 12-19 years; M = 15.1 years; 53.8% female; 61.5% Hispanic/Latinx White) and 13 mothers, recruited from an outpatient pediatric endocrinology clinic in South Florida, who participated in semi-structured interviews via video teleconference. Thematic content analysis was used to evaluate participants' responses.Results: Adolescents and their mothers reported positive experiences with the clinic's psychosocial screening procedures and appreciated meeting with the psychology team during visits. They wanted the clinic to offer more opportunities for peer support. Mothers highlighted barriers to seeking mental health care outside of the clinic and the importance of mental health professionals understanding diabetes. Mothers also wanted the clinic to offer more on-site therapeutic services.Discussion: Study participants valued psychosocial screening and supported addressing mental health as a routine part of diabetes comprehensive care.

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Reducing the Impacts of Mental Health Stigma Through Integrated Primary Care: An Examination of the Evidence

Cited by 8 publications

References 77 publications

National trends of suicidal ideation and mental health services use among US adults with opioid use disorder, 2009–2020

National trends of suicidal ideation and mental health services use among US adults with opioid use disorder, 2009–2020

Primary care-based mindfulness intervention for posttraumatic stress disorder and depression symptoms among Black adults: A pilot feasibility and acceptability randomized controlled trial.

Psychosocial screening in a pediatric diabetes clinic: Adolescents' and mothers' perspectives

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