Journal ArticleDOI
The Evolution of Behavioral Primary Care.
Reads0
Chats0
TLDR
The authors conclude that the behavioral health care system is entering an era of flux as it experiments with ways of integrating behavioral and primary care.Abstract:
The financing, organization, and delivery of behavioral health care services has undergone dramatic change in the past 25 to 30 years. The authors trace the evolution of behavioral health care delivery in the United States over the past several decades and find (a) that the value of mental health "carve-outs" has diminished greatly and that they are being replaced by "carve-ins," (b) that primary care physicians (PCPs) are becoming a primary source of mental health care secondary to the introduction of new medications, and (c) that PCP treatment of mental health disorders is suboptimal. The authors conclude that the behavioral health care system is entering an era of flux as it experiments with ways of integrating behavioral and primary care. Opportunities for psychologists are explored.read more
Citations
More filters
Book
Integrated Behavioral Health in Primary Care: Step-by-Step Guidance for Assessment and Intervention
TL;DR: This comprehensive book belongs on the bookshelf of a range of clinicians including psychologists and social workers, as well as family physicians, physician assistants, nurses, and health care educators.
Journal Article
Understanding the expanding role of primary care physicians (PCPs) to primary psychiatric care physicians (PPCPs): enhancing the assessment and treatment of psychiatric conditions
TL;DR: PCPs are serving a useful role in providing psychiatric treatment to many of their patients and using a more structured psychiatric assessment method in practice could ultimately strengthen the assessment and treatment of psychiatric conditions in primary care settings.
Journal ArticleDOI
Economic Utility: Combinatorial Pharmacogenomics and Medication Cost Savings for Mental Health Care in a Primary Care Setting
TL;DR: It is found that PCPs treat the majority of mental health patients receiving psychotropic medication prescriptions, including treatment-resistant patients, and PCPs congruent with combinatorial PGx testing provided the most medication cost savings for payers and patients.
Journal ArticleDOI
Integral Healthcare: The Benefits and Challenges of Integrating Complementary and Alternative Medicine with a Conventional Healthcare Practice
TL;DR: Today’s medicine is in the midst of an undeniable crisis; the development of an integral healthcare system that is rooted in appropriate regulation and supported by rigorous scientific evidence is the direction that many models of integrative healthcare are moving towards in the 21st century.
Journal ArticleDOI
Bringing psychotherapy to primary care: Innovations and challenges.
TL;DR: The importance of finding feasible ways to bring psychotherapy to primary care is discussed, and the compatibility of interventions either specifically adapted for primary care or consistent with its constraints is assessed.
References
More filters
Journal ArticleDOI
Depression Following Myocardial Infarction: Impact on 6-Month Survival
TL;DR: Major depression in patients hospitalized following an MI is an independent risk factor for mortality at 6 months and its impact is at least equivalent to that of left ventricular dysfunction (Killip class) and history of previous MI.
Journal ArticleDOI
Collaborative management to achieve treatment guidelines : impact on depression in primary care
Wayne Katon,Michael Von Korff,Elizabeth H. B. Lin,Edward A. Walker,Greg Simon,Terry Bush,Patricia Robinson,Joan Russo +7 more
TL;DR: A multifaceted intervention consisting of collaborative management by the primary care physician and a consulting psychiatrist, intensive patient education, and surveillance of continued refills of antidepressant medication improved adherence to antidepressant regimens in patients with major and with minor depression and resulted in more favorable depressive outcomes.
Journal ArticleDOI
Sertraline Treatment of Major Depression in Patients With Acute MI or Unstable Angina
Alexander H. Glassman,Christopher M. O'Connor,Robert M. Califf,Karl Swedberg,Peter J. Schwartz,J. Thomas Bigger,K. Ranga Rama Krishnan,Louis T. van Zyl,J. Robert Swenson,Mitchell S. Finkel,Charles Landau,Peter A. Shapiro,Carl J. Pepine,Jack Mardekian,Wilma Harrison +14 more
TL;DR: It is suggested that sertraline is a safe and effective treatment for recurrent depression in patients with recent MI or unstable angina and without other life-threatening medical conditions.
Journal ArticleDOI
Depression, disability days, and days lost from work in a prospective epidemiologic survey
TL;DR: The threshold for identifying clinically significant depression may need to be reevaluated to include persons with fewer symptoms but measurable morbidity, only by changing the nosology can the societal impact of depression be adequately addressed.
Journal ArticleDOI
Impact of disseminating quality improvement programs for depression in managed primary care: A randomized controlled trial.
Kenneth B. Wells,Cathy D. Sherbourne,Michael Schoenbaum,Naihua Duan,Lisa S. Meredith,Jürgen Unützer,Jeanne Miranda,Maureen F. Carney,Lisa V. Rubenstein +8 more
TL;DR: When managed primary care practices implemented QI programs that improve opportunities for depression treatment without mandating it, quality of care, mental health outcomes, and retention of employment of depressed patients improved over a year, while medical visits did not increase overall.