Perceptions of health managers and professionals about mental health and primary care integration in Rio de Janeiro: a mixed methods study

Community-based primary mental health care is recommended in low and middle-income countries. The Brazilian Health System has been restructuring primary care by expanding its Family Health Strategy. Due to mental health problems, psychosocial vulnerability and accessibility, Matrix Support teams are being set up to broaden the professional scope of primary care. This paper aims to analyse the perceptions of health professionals and managers about the integration of primary care and mental health.

Person-Centered Integrated Care for Chronic Kidney Disease

The effectiveness of person-centered integrated care strategies for CKD is uncertain. This study conducted a systematic review and meta-analysis of randomized, controlled trials to assess the effect of person-centered integrated care for CKD.
It searched MEDLINE, Embase, and Cochrane Central Register of Controlled Trials (from inception to April of 2016), and selected randomized, controlled trials of person-centered integrated care interventions with a minimum follow-up of 3 months. Random-effects meta-analysis was used to assess the effect of person-centered integrated care.

A year of integrated care systems: Reviewing the journey so far

Where once the primary purpose of the health and care system was to provide
episodic treatment for acute illness, it now needs to deliver joined-up and proactive support for growing numbers of older people and people living with long-term conditions and complex needs.
In March 2017, NHS England set out an ambition to ‘use the next several years to make the biggest national move to integrated care of any major western country’. This aim is now being pursued through the development of sustainability and transformation partnerships (STPs) – local ‘place?based’ partnerships of NHS and local authority organisations. The most advanced local partnerships have been asked to develop ‘integrated care systems’ (ICSs). These systems will take more control of funding and services across local areas.
The purpose of this qualitative study was to understand how ICSs are being
developed in different parts of the country and to identify lessons for local ...

Why integrated care already owns the future

Integrated care has certainly arrived in the primary care clinic. Evidence and momentum began building 20 years ago with the demonstrated effectiveness of collaborative care programs for depression and anxiety disorders in primary care. Since then, various forms of integrated care have been repeatedly proven effective across a range of care settings, patient populations, languages and cultures.

Integrated care models are well adapted to thrive during the Fourth Industrial Revolution in health care. Because integrated care has embraced flexibility and disruption, integrated care models will succeed—or even dominate—in a future that will demand flexibility.

Addressing Common Challenges in the Implementation of Collaborative Care for Mental Health: The Penn Integrated Care Program

The purpose of this article was to develop and implement a new model of collaborative care that includes a triage and referral management system. The authors present initial implementation metrics using the Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework.  

Paediatric integrated care in the primary care setting: A scoping review of populations served, models used and outcomes measured

Paediatric integrated care (PIC), which involves primary care and behavioural health clinicians working together with patients and families, has been promoted as a best practice in the provision of care. In this context, behavioural health includes behavioural elements in the care of mental health and substance abuse conditions, chronic illness and physical symptoms associated with stress, and addressing health behaviours. Models of and contexts in which PIC has been applied vary, as do the outcomes and measures used to determine its value. Thus, this study seeks to better understand (1) what paediatric subpopulations are receiving integrated care, (2) which models of PIC are being studied, (3) what PIC outcomes are being explored and what measures and strategies are being used to assess those outcomes, and (4) whether the various models are resulting in positive outcomes. These questions have significant policy and clinical implications, given current national- and state-level efforts aimed ...

Development and Implementation of an Integrated Care Fellowship

Integrated care is a common approach to leverage scarce psychiatric resources to deliver mental health care in primary care settings. The Integrated Care clinical fellowship serves as a model for training programs seeking to provide training in clinical and systems-based skills needed for practicing integrated care. Whether such training is undertaken as a standalone fellowship or incorporated into existing consultation-liaison psychiatry programs, such skills are increasingly valuable as integrated care becomes commonplace in practice.  

Social workers in integrated care beyond primary care: a scoping review

Social workers are key members of integrated care (IC) teams, yet there is limited research on the presence and roles of social workers on IC teams. Research literature from 2014 to 2021 was identified using the following search engines: Academic Search Complete, PsycINFO, CINAHL Plus, SocINDEX and MEDLINE. An exploratory search was conducted in January 2021 and an updated search was conducted in August 2021. This search resulted in 802 references, 50 of which met criteria for full-text review. Nine articles were identified through supplemental searching. 20 articles were included in the final review. Of the 20 studies included, most were randomized control trials (45%; n = 9). Studies varied across settings including specialty care (40%; n = 8), community-based practices (35%; n = 7), and primary care (25%; n = 5). Social workers engaged in a variety of roles including behavioral interventions, care coordination, and intake assessment. Social workers are engaged in IC ...

Successful ingredients of effective Collaborative Care programs in low- and middle-income countries: A rapid review

Integrating mental health care in primary healthcare settings is a compelling strategy to address the mental health treatment gap in low- and middle-income countries (LMICs). Collaborative Care is the integrated care model with the most evidence supporting its effectiveness, but most research has been conducted in high-income countries. Efforts to implement this complex multi- component model at scale in LMICs will be enhanced by understanding the model components that have been effective in LMIC settings. Following Cochrane Rapid Reviews Methods Group recommendations, we conducted a rapid review to identify studies of the effectiveness of Collab- orative Care for priority adult mental disorders of mhGAP (mood and anxiety disorders, psychosis, substance use disorders and epilepsy) in outpatient medical settings in LMICs. Article screening and data extraction were performed using Covidence software. Data extraction by two authors utilized a checklist of key components of effective interventi ns. Information was aggregated to examine ...