Client Outcomes Associated With Interprofessional Care in a Community Mental Health Outpatient Program
Publication: Canadian Journal of Community Mental Health
22 December 2016
Abstract
Interprofessional care (IPC) represents a high degree of collaboration among health professionals to provide comprehensive treatment to clients. Despite increased uptake of IPC in mental health care, few studies have examined its clinical effectiveness in actual practice. A retrospective cohort study examined the treatment outcomes for 183 outpatients with chronic and comorbid mental health difficulties treated with IPC in a community mental health setting. Multilevel modelling demonstrated that clients reported statistically significant improvement in mental health symptoms and functioning during IPC, relative to a waitlist interval. Furthermore, fewer clients reported clinically significant difficulty with symptoms and functioning over the course of treatment with IPC. Findings suggest that IPC may be an effective treatment in outpatient community mental health settings for Canadian adults presenting with chronic and comorbid psychopathology and affected psychosocial functioning.
Résumé
Les pratiques interprofessionnelle requièrent un niveau élevé de collaboration entre les professionnels de la santé afin d’offrir un traitement global au client. Malgré le nouvel intérêt pour les pratiques interprofessionnelle dans le domaine des soins de santé mentale, peu d’études se sont penchées sur leur efficacité clinique. Une étude de cohorte rétrospective a examiné les résultats du traitement chez 183 clients avec des troubles chroniques et concomitants de santé mentale traités avec les pratiques interprofessionnelles dans un établissement de santé mentale communautaire. La modélisation multiniveaux a montré des améliorations statistiquement significatives quant aux symptômes de troubles mentaux et au fonctionnement pendant les pratiques interprofessionnelle, par rapport aux périodes où le client est en attente de traitement. De plus, moins de clients font état de problèmes cliniquement significatifs en matière de symptômes et de fonctionnement pendant la durée des traitements de pratiques interprofessionnelle. Des données indiquent que les pratiques interprofessionnelle peuvent constituer un traitement efficace dans un milieu de soins de santé mentale communautaire en consultation externe, pour les Canadiens adultes ayant des troubles psychopathologiques chroniques et concomitants ainsi que des problèmes de fonctionnement psychosocial.
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References
American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text rev.). Washington, DC: Author.
Archer J., Bower P., Gilbody S., Lovell K., Richards D., Gask L., and Coventry P. Collaborative care for depression and anxiety Cochrane Database of Systematic Reviews 2012 2012 10
Bauer M., McBride L., Williford W., Glick H., Kinosian B., Altshuler L., and Sajatovic M. Collaborative care for bipolar disorder: Part II. Impact on clinical outcome, function, and costs Psychiatric Services 2006 57 7 937 -945
Burns, T. (2004). Community mental health teams: A guide to current practices. Oxford, UK: Oxford University Press.
Craven M. A. and Bland R. Better practices in collaborative mental health care: An analysis of the effective base The Canadian Journal of Psychiatry 2006 51 Suppl. 1 2 -3 Retrieved from http://ww1.cpa-apc.org/Publications/CJP/supplements/may2006/index.asp
D’Amour D., Ferrada-Videla M., Rodriguez L. S. M., and Beaulieu M.-D. The conceptual basis for interprofessional collaboration: Core concepts and theoretical frameworks Journal of Interprofessional Care 2005 19 116 -131
Eisen S. V., Dill D. L., and Grob M. C. Reliability and validity of a brief client-report instrument for psychiatric outcome evaluation Hospital and Community Psychiatry 1994 45 242 -247
Eisen S. V. and Speredelozzi A. Usefulness of the BASIS-32 in evaluating program level outcomes Journal of Psychiatric Practice 2003 9 5 -6
Eisen S. V., Wilcox M., Leff H. S., Schaefer E., and Culhane M. A. Assessing behavioral health outcomes in outpatient programs: Reliability and validity of the BASIS-32 The Journal of Behavioral Health Services & Research 1999 26 1 5 -17
Enhancing Interdisciplinary Collaboration in Primary Health Care Initiative. (2005). Enhancing interdisciplinary collaboration in primary health care in Canada. Ottawa, ON: Author.
Gagné, M.-A. (2005). Advancing the agenda for collaborative mental health care. (Paper No. 1). Retrieved from Collaborative Mental Health Care website: http://www.shared-care.ca/page.aspx?menu=69&app=266&cat1=744&tp=2&lk=no
Gunn J., Diggens J., Hegarty K., and Blashki G. A systematic review of complex system interventions designed to increase recovery from depression in primary care BMC Health Services Research 2006 6 88
Haggarty J., Klein R., Chaudhuri B., Bourdeau D., and McKinnon T. After shared care: Clients’ symptoms and functioning 3 to 6 months following care at a rural shared mental health care clinic Canadian Journal of Community Mental Health 2008 27 2 47 -54
Health Canada. (2004). Interdisciplinary education for collaborative, client-centred practice: Research and findings report. Retrieved from http://www.hc-sc.gc.ca/hcs-sss/pubs/hhrhs/2006-iecps-fipccp-workatel/index-eng.php
HealthForceOntario. (2007). Interprofessional care: A blueprint for action in Ontario. Retrieved from http://www.healthforceontario.ca/UserFiles/file/PolicymakersResearchers/ipc-blueprint-july-2007-en.pdf
Hedrick S. C., Chaney E. F., Felker B., Liu C.-F., Hasenberg N., Heagerty P., and Katon W. Effectiveness of collaborative care depression treatment in veterans’ affairs primary care Journal of General Internal Medicine 2003 18 1 9 -16
Interprofessional Education Collaborative Expert Panel. (2011). Core competencies for interprofessional practice: Report of an expert panel. Washington, DC: Interprofessional Education Collaborative.
Jerrell J. M. Behaviour and symptom identification scale 32: Sensitivity to change over time Journal of Behavioral Health Services & Research 2005 32 3 341 -346
Kates N., Gagné M. A., and Whyte J. M. Collaborative mental health care in Canada: Looking back and looking ahead Canadian Journal of Community Mental Health 2008 27 2 1 -4
Kates N., Mazowita G., Lemire F., Jayabarathan A., Bland R., Selby P., and Audet D. The evolution of collaborative mental health care in Canada: A shared vision for the future The Canadian Journal of Psychiatry 2011 56 5 1 -10 Retrieved from http://publications.cpa-apc.org/media.php?mid=1139
Katon W., Robinson P., Von Korff M., Lin E., Bush T., Ludman E., and Walker E. A multifaceted intervention to improve treatment of depression in primary care Archives of General Psychiatry 1996 53 10 924 -932
Katon W., Von Korff M., Lin E., Simon G., Walker E., Bush T., and Ludman E. Collaborative management to achieve depression treatment guidelines Journal of Clinical Psychology 1997 58 Suppl. 1 20 -23 Retrieved from http://www.psychiatrist.com/jcp/article/Pages/1997/v58s01/v58s0105.aspx
Kazdin A. E. and Blase S. L. Rebooting psychotherapy research and practice to reduce the burden of mental illness Perspectives on Psychological Science 2011 6 1 21 -37
Kroenke K., Spitzer R. L., Williams J. B., Linzer M., Hahn S. R., deGruy F. V. III, and Brody D. Physical symptoms in primary care: Predictors of psychiatric disorders and functional impairment Archives of Family Medicine 1994 3 9 774 -779 Retrieved from http://triggered.edina.clockss.org/ServeContent?url=http%3A%2F%2Farchfami.ama-assn.org%2Fcgi%2Freprint%2F3%2F9%2F774
Lin E. H., Katon W., Von Korff M., Tang L., Williams J. W. Jr, Kroenke K., and Unützer J. Effect of improving depression care on pain and functional outcomes among older adults with arthritis: A randomized controlled trial The Journal of the American Medical Association 2003 290 18
McLoughlin K. A. and Geller J. L. Interdisciplinary treatment planning in inpatient settings: From myth to model Psychiatric Quarterly 2010 81 3 263 -277
Mental Health Commission of Canada. (2009). Toward recovery and well-being: A framework for a mental health strategy for Canada. Calgary, AB: Author.
Mulvale G., Danner U., and Pasic D. Advancing community-based collaborative mental health care through interdisciplinary family health teams in Ontario Canadian Journal of Community Mental Health 2008 27 2 55 -73
Oandasan I. and Reeves S. Key elements for interprofessional education. Part 1: The learner, the educator and the learning context Journal of Interprofessional Care 2005 19 Suppl. 1 21 -38
Paulter, K., & Gagné, M.-A. (2005). Annotated bibliography of collaborative mental health care. (Paper No. 3). Retrieved from Collaborative Mental Health Care website: http://www.shared-care.ca/page.aspx?menu=69&app=266&cat1=744&tp=2&lk=no
Perreault K. and Careau E. Interprofessional collaboration: One or multiple realities? Journal of Interprofessional Care 2012 26 4 256 -258
Preachey, D., Hicks, V., & Adams, O. (2013). An imperative for change: Access to psychological services for Canada: A report to the Canadian Psychological Association. Retrieved from http://www.cpa.ca/docs/File/Position/An_Imperative_for_Change.pdf
Reeves S., Goldman J., Gilbert J., Tepper J., Silver I., Suter E., and Zwarenstein M. A scoping review to improve conceptual clarity of interprofessional interventions Journal of Interprofessional Care 2011 25 3 167 -174
Reilly S., Planner C., Gask L., Hann M., Knowles S., Druss B., and Lester H. Collaborative care approaches for people with severe mental illness Cochrane Database Systematic Reviews 2013 2013 11 1 -57
Richards D. A., Hill J. J., Gask L., Lovell K., Chew-Graham C., Bower P., and Barkham M. Clinical effectiveness of collaborative care for depression in UK primary care (CADET): Cluster randomised controlled trial British Medical Journal 2013 347 f4913
Rossen E. K., Bartlett R., and Herrick C. A. Interdisciplinary collaboration: The need to revisit Issues in Mental Health Nursing 2008 29 387 -396
Schmitt M. H. Collaboration improves the quality of care: Methodological challenges and evidence from US health care research Journal of Interprofessional Care 2001 15 1 47 -66
Schofield R. F. and Amodeo M. Interdisciplinary teams in health care and human service settings: Are they effective? Health & Social Work 1999 24 3 210 -219
Skultety K. M. and Zeiss A. The treatment of depression in older adults in the primary care setting: An evidencebased review Health Psychology 2006 25 6 665 -674
Ungar T., Goldman S., and Marcus M. Reversed shared care in mental health: Bringing primary physical health care to psychiatric patients Canadian Journal of Community Mental Health 2013 32 3 1 -16
Vines R. F., Richards J. C., Thomson D. M., Brechman-Toussaint M., Kluin M., and Vesely L. Clinical psychology in general practice: A cohort study The Medical Journal of Australia 2004 181 2 74 -77 Retrieved from https://www.mja.com.au/system/files/issues/181_02_190704/vin10194_fm.pdf
Wampold, B. E. (2001). The great psychotherapy debate: Models, methods and findings. Mahwah, NJ: Lawrence Erlbaum Associates.
Westen D., Novotny C. M., and Thompson-Brenner H. The empirical status of empirically supported psychotherapies: Assumptions, findings, and reporting in controlled clinical trials Psychological Bulletin 2004 130 4 631 -663
Wise E. A. Methods for analyzing psychotherapy outcomes: A review of clinical significance, reliable change, and recommendations for future directions Journal of Personality Assessment 2004 82 1 50 -59
World Health Organization. (2010). Framework for action on interprofessional education and collaborative practice. Retrieved from http://www.who.int/hrh/resources/framework_action/en/
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Published In
Canadian Journal of Community Mental Health
Volume 35 • Number 3 • December 2016
Pages: 83 - 96
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Version of record online: 22 December 2016
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Gregory K. Tippin, K. Amanda Maranzan, and Mary Ann Mountain. 2016. Client Outcomes Associated With Interprofessional Care in a Community Mental Health Outpatient Program. Canadian Journal of Community Mental Health.
35(3): 83-96. https://doi.org/10.7870/cjcmh-2016-042
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