Primary Mental Health Care in the Family Health Team Setting: Tracking Patient Care from Referral to Outcome
Publication: Canadian Journal of Community Mental Health
26 August 2015
Abstract
This study reports on the mental health services provided at a large, multi-site Ontario family health team (FHT) across one year of service delivery, describing a unique model of collaboration between psychology, social work, and primary care medicine. Patient satisfaction ratings and clinical outcomes were examined pre- and post-treatment. Referral patterns, presenting concerns, wait times, and treatment services are also reported. Significant positive outcomes were observed and patient satisfaction was very high. Importantly, short wait times (m = 6.4 weeks) were found relative to traditional mental health settings.
Résumé
Cette étude traite des services en santé mentale fournis par une équipe de santé familiale de l'Ontario dans plusieurs établissements sur une période d'un an et présente un modèle unique de collaboration entre la psychologie, le travail social et la médecine de premier recours. Le niveau de satisfaction des patients et patientes et les résultats cliniques ont été évalués avant et après les traitements. Les pratiques en matière d'orientation, les problèmes initiaux, les délais d'attente et les traitements ont également été analysés. Des résultats positifs significatifs ont été observés et la satisfaction des patients et patientes a été très élevée. D'abord et avant tout, les délais d'attente sont courts (m = 6,4 semaines) comparativement aux environnements de santé mentale traditionnels.
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References
Adam P., Brandenburg D. L., Bremer K. L., and Nordstrom D. L. Effects of team care of frequent attenders on patients and physicians Families, Systems, & Health 2010 28 3 247 -257 doi:https://doi.org/10.1037/a0020944
Anssea M., Dierick M., Buntinkx F., Cnockaert P., De Smedt J., Van D. H., and Vander Mijnsbrugge D. High prevalence of mental disorders in primary care Journal of Affective Disorders 2004 78 1 49 -55 doi:https://doi.org/10.1016/S0165-0327(02)00219-7
Astin J. A., Goddard T. G., and Forys K. Barriers to the integration of mind-body medicine: perceptions of physicians, residents, and medical students EXPLORE: Journal of Science and Healing 2005 1 4 278 -283
Azrin S. T. High-impact mental health—Primary care research for patients with multiple comorbidities Psychiatric Services 2014 65 4 406 -409 doi:https://doi.org/10.1176/appi.ps.201300537
Bryan C. J., Corso M. L., Corso K. A., Morrow C. E., Kanzler K. E., and Ray-Sannerud B. Severity of mental health impairment and trajectories of improvement in an integrated primary care clinic Journal of Consulting and Clinical Psychology 2012 80 3 396 -403 doi:https://doi.org/10.1037/a0027726
Campbell A. and Hemsley S. Outcome rating scale and session rating scale in psychological practice: Clinical utility of ultra-brief measures Clinical Psychologist 2009 13 1 1 -9 doi:https://doi.org/10.1080/13284200802676391
Chang G., Weiss A. P., Orav E. J., and Rauch S. L. Predictors of frequent emergency department use among patients with psychiatric illness General Hospital Psychiatry 2014 36 6 716 -720 doi:https://doi.org/10.1016/j.genhosppsych.2014.09.010
Chomienne M., Grenier J., Gaboury I., Hogg W., Ritchie P., and Farmanova-Haynes E. Family doctors and psychologists working together: doctors’ and patients’ perspectives Journal of Evaluation in Clinical Practice 2011 17 282 -287
Craven M. and Bland R. Shared mental healthcare: a bibliography and overview Canadian Journal of Psychiatry 2002 47 51 -104
Craven M., Cohen M., Campbell D., Williams J., and Kates N. Mental health practices of Ontario family physicians: a study using qualitative methodology Canadian Journal of Psychiatry 1997 42 943 -949
Doey T., Hines P., Myslik B., Leavey J. E., and Seabrook J. A. Creating primary care access for mental health care clients in a community mental health setting Canadian Journal of Community Mental Health 2008 27 2 129 -138
Duncan, B. L., Miller, S. D., & Sparks, J. A. (2003a). Child outcome rating scale. Retrieved from www.talkingcure.com
Duncan, B. L., Miller, S. D., & Sparks, J. A. (2003b). Child session rating scale. Retrieved from www.talkingcure.com
Duncan B. L., Miller S. D., Sparks J. A., Claud D. A., Reynolds L. R., Brown J., and Johnson L. D. The session rating scale: preliminary psychometric properties of a “working” alliance scale Journal of Brief Therapy 2003 3 1 3 -12
Farrar S., Kates N., Crustolo A. M., and Nikolaou L. Integrated model for mental health care. Are health care providers satisfied with it? Canadian Family Physician 2001 47 2483 -2488
Firth M. T., Dyer M., Marsden H., Savage D., and Mohamad H. Non-statutory mental health social work in primary care: A chance for renewal? British Journal of Social Work 2004 34 2 145 -163 doi:https://doi.org/10.1093/bjsw/bch038
Fischer L. R., Heinrich R. L., Davis T. F., Peek C. J., and Lucas S. F. Mental health and primary care in an HMO Families, Systems, & Health 1997 15 4 379 -391 doi:https://doi.org/10.1037/h0089835
Gask L., Sibbald B., and Creed F. Evaluating models of working at the interface between mental health services and primary care The British Journal of Psychiatry 1997 170 6 -11 Retrieved from http://search.proquest.com.ezproxy.library.yorku.ca/docview/619118437?accountid=15182
Gathchel, R. J., Oordt, M. S., & Gatchel, R. J. (2003). Clinical health psychology in the primary care setting: An overview. Clinical health psychology and primary care: Practical advice and clinical guidance for successful collaboration (pp. 3–19). American Psychological Association. https://doi.org/10.1037/10592-001
Geist R., Weinstein M., Walker L., and Campo J. V. Medically unexplained symptoms in young people: The doctor's dilemma Paediatrics & Child Health 2008 13 6 487 -491
Goldberg D., Jackson G., Gater R., Campbell M., and Jennett N. The treatment of common mental disorders by a community team based in primary care: A cost-effectiveness study Psychological Medicine 1996 26 3 487 -492 Retrieved from http://search.proquest.com.ezproxy.library.yorku.ca/docview/618850680?accountid=15182
Goossen R. B., Staley J. D., and Pearson M. L. Does the introduction of shared care therapists in primary health care impact clients’ mental health symptoms and functioning? Canadian Journal of Community Mental Health 2008 27 2 37 -46
Gunn W. B. and Blount A. Primary care mental health: A new frontier for psychology Journal of Clinical Psychology 2009 65 3 235 -252 doi:https://doi.org/10.1002/jclp.20499
Haggarty J. M., Jarva J. A., Cernovsky Z., Karioja K., and Martin L. Wait time impact of co-located primary care mental health services: The effect of adding collaborative care in northern Ontario The Canadian Journal of Psychiatry / La Revue Canadienne De Psychiatrie 2012 57 1 29 -33
Hooper L. M. Mental health services in primary care: Implications for clinical mental health counselors and other mental health providers Journal of Mental Health Counseling 2014 36 2 95 -98
Kates, N. (2008). Integrating mental health services into primary care: The Hamilton FHT mental health program (pp. 71–82). New York, NY, US: Springer Science + Business Media, New York, NY. https://doi.org/10.1007/978-0-387-76894-6_7
Kates N., Craven M., Crustolo A. M., Nikolaou L., and Allen C. Integrating mental health services within primary care: A Canadian program General Hospital Psychiatry 1997 19 5 324 -332
Kates N., Craven M. A., Crustolo A., Nikolaou L., Allen C., and Farrar S. Sharing care: The psychiatrist in the family physician's office The Canadian Journal of Psychiatry / La Revue Canadienne De Psychiatrie 1997 42 9 960 -965 Retrieved from http://search.proquest.com.ezproxy.library.yorku.ca/docview/619207726?accountid=15182
Kates N., Crustolo A., Farrar S., and Nikolaou L. Counsellors in primary care: Benefits and lessons learned The Canadian Journal of Psychiatry / La Revue Canadienne De Psychiatrie 2002 47 9 857 -862
Kates N., Crustolo A., Farrar S., Nikolaou L., Ackerman S., and Brown S. Mental health care and nutrition: Integrating specialist services into primary care Canadian Family Physician 2002 48 1898 -1903
Kates N., George L., Crustolo A. M., and Mach M. Findings from a comparison of mental health services in primary care and outpatient mental health services Canadian Journal of Community Mental Health 2008 27 2 93 -103 Retrieved from http://search.proquest.com.ezproxy.library.yorku.ca/docview/621812699?accountid=15182
Lesser J. G. Clinical social work and family medicine: A partnership in community service Health and Social Work 2000 25 2 119 -126
McDaniel S. H., deGruy III, and Frank V. An introduction to primary care and psychology American Psychologist 2014 69 4 325 -331 doi:https://doi.org/10.1037/a0036222
Miller, S. D., & Duncan, B. L., (2000). Outcome rating scale. Retrieved from www.talkingcure.com
Miller, S. D., & Duncan, B. L., & Johnson, L. (2002). Session rating scale. Retrieved from www.talkingcure.com
Miller S. D., Duncan B. L., Brown J., Sparks J., and Claud D. The outcome rating scale: A preliminary study of the reliability, validity, and feasibility of a brief visual analog measure Journal of Brief Therapy 2003 2 2 91 -100
Miranda, J., Hohnmann, A. A., & Attikisson, C. A. (1994). Epidemiology of mental health disorders in primary care. San Francisco, CA: Jossey-Bass.
Nash J. M., McKay K. M., Vogel M. E., and Masters K. S. Functional roles and foundational characteristics of psychologists in integrated primary care Journal of Clinical Psychology in Medical Settings 2012 19 1 93 -104 doi:https://doi.org/10.1007/s10880-011-9290-z
Ní Raghallaigh M., Allen M., Cunniffe R., and Quin S. Experiences of social workers in primary care in Ireland Social Work in Health Care 2013 52 10 930 -946 doi:https://doi.org/10.1080/00981389.2013.834030
Ontario Ministry of Health and Long Term Care. (2013). FHT to Print. Retrieved March 3, 2015, from http://www.health.gov.on.ca/en/pro/programs/fht/docs/fht_news_201303.pdf
Ontario Ministry of Health and Long Term Care. (2014). Family Health Teams. Retrieved April 10, 2014, from http://www.health.gov.on.ca/en/pro/programs/fht/
Petterson S., Miller B. F., Payne-Murphy J., and Phillips R. L. Jr Mental health treatment in the primary care setting: Patterns and pathways Families, Systems, & Health 2014 32 2 157 -166 doi:https://doi.org/10.1037/fsh0000036
Pollard R. Q. Jr, Betts W. R., Carroll J. K., Waxmonsky J. A., Barnett S., deGruy F. V. III, and Kellar-Guenther Y. Integrating primary care and behavioral health with four special populations: Children with special needs, people with serious mental illness, refugees, and deaf people American Psychologist 2014 69 4 377 -387 doi:https://doi.org/10.1037/a0036220
Ray-Sannerud B., Dolan D. C., Morrow C. E., Corso K. A., Kanzler K. E., Corso M. L., and Bryan C. J. Longitudinal outcomes after brief behavioral health intervention in an integrated primary care clinic Families, Systems, & Health 2012 30 1 60 -71 doi:https://doi.org/10.1037/a0027029
Rock B. D. and Cooper M. Social work in primary care: A demonstration student unit utilizing practice research Social Work in Health Care 2000 31 1 1 -17
Schoen C., Osborn R., Squires D., Doty M., Pierson R., and Applebaum S. New 2011 survey of patients with complex care needs in eleven countries finds that care is often poorly coordinated Health Affairs 2011 30 12 2437 -2448
School–Community Connections. A report from people for education. (2012). Retrieved February 25, 2015 from http://www.peopleforeducation.ca/wp-content/uploads/2013/01/school-community-connections.pdf
Simon G. E. Psychiatric disorder and functional somatic symptoms as predictors of health care use Psychiatric Medicine 1992 146 69 -72
Stancin T. and Perrin E. C. Psychologists and pediatricians: Opportunities for collaboration in primary care American Psychologist 2014 69 4 332 -343 doi:https://doi.org/10.1037/a0036046
\Swenson J. R., Aubry T., Gillis K., Macphee C., Busing N., Kates N., Pantin S., and Runnels V. Development and implementation of a collaborative mental health care program in a primary care setting: The Ottawa share program Canadian Journal of Community Mental Health 2008 27 2 75 -91
Tata P., Eagle A., and Green J. Does providing more accessible primary care psychology services lower the clinical threshold for referrals? British Journal of General Practice 1996 46 469 -472 Retrieved from http://www.rcgp.org.uk/publications/bjgp.aspx
Tessler R., Mechanic D., and Dimond M. The effect of psychological distress on physician utilization: A prospective study Journal of Health and Social Behavior 1976 17 4 353 -364
The Hincks-Dellcrest Centre Annual Report (2013–2014). Caring and Courageous. Retrieved February 25, 2015 from http://www.hincksdellcrest.org/Home/About-Us/Annual-Report/Annual-Report-2013-2014.aspx
van Orden M., Hoffman T., Haffmans J., Spinhoven P., and Hoencamp E. Collaborative mental health care versus care as usual in a primary care setting: A randomized controlled trial Psychiatric Services 2009 60 1 74 -79 doi:https://doi.org/10.1176/appi.ps.60.1.74
Vickers K. S., Ridgeway J. L., Hathaway J. C., Egginton J. S., Kaderlik A. B., and Katzelnick D. J. Integration of mental health resources in a primary care setting leads to increased provider satisfaction and patient access General Hospital Psychiatry 2013 35 5 461 -467 doi:https://doi.org/10.1016/j.genhosppsych.2013.06.011
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Published In
Canadian Journal of Community Mental Health
Volume 34 • Number 3 • November 2015
Pages: 51 - 65
History
Version of record online: 26 August 2015
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CordeiroKristina, ForougheMirisse, and MastorakosTessie. 2015. Primary Mental Health Care in the Family Health Team Setting: Tracking Patient Care from Referral to Outcome. Canadian Journal of Community Mental Health.
34(3): 51-65. https://doi.org/10.7870/cjcmh-2015-021
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