Integrating Behavioral Health into Primary Care. 2016

Peter M McGough, and Amy M Bauer, and Laura Collins, and David C Dugdale
1 UW Medicine Neighborhood Clinics , and Department of Family Medicine, Seattle, Washington.

Depression is one of the more common diagnoses encountered in primary care, and primary care in turn provides the majority of care for patients with depression. Many approaches have been tried in efforts to improve the outcomes of depression management. This article outlines the partnership between the University of Washington (UW) Neighborhood Clinics and the UW Department of Psychiatry in implementing a collaborative care approach to integrating the management of anxiety and depression in the ambulatory primary care setting. This program was built on the chronic care model, which utilizes a team approach to caring for the patient. In addition to the patient and the primary care provider (PCP), the team included a medical social worker (MSW) as care manager and a psychiatrist as team consultant. The MSW would manage a registry of patients with depression at a clinic with several PCPs, contacting the patients on a regular basis to assess their status, and consulting with the psychiatrist on a weekly basis to discuss patients who were not achieving the goals of care. Any recommendation (eg, a change in medication dose or class) made by the psychiatrist was communicated to the PCP, who in turn would work with the patient on the new recommendation. This collaborative care approach resulted in a significant improvement in the number of patients who achieved care plan goals. The authors believe this is an effective method for health systems to integrate mental health services into primary care. (Population Health Management 2016;19:81-87).

UI MeSH Term Description Entries
D011320 Primary Health Care Care which provides integrated, accessible health care services by clinicians who are accountable for addressing a large majority of personal health care needs, developing a sustained partnership with patients, and practicing in the context of family and community. (JAMA 1995;273(3):192) Primary Care,Primary Healthcare,Care, Primary,Care, Primary Health,Health Care, Primary,Healthcare, Primary
D003299 Cooperative Behavior The interaction of two or more persons or organizations directed toward a common goal which is mutually beneficial. An act or instance of working or acting together for a common purpose or benefit, i.e., joint action. (From Random House Dictionary Unabridged, 2d ed) Compliant Behavior,Behavior, Compliant,Behavior, Cooperative,Compliant Behaviors,Cooperative Behaviors
D003863 Depression Depressive states usually of moderate intensity in contrast with MAJOR DEPRESSIVE DISORDER present in neurotic and psychotic disorders. Depressive Symptoms,Emotional Depression,Depression, Emotional,Depressive Symptom,Symptom, Depressive
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000554 Ambulatory Care Facilities Those facilities which administer health services to individuals who do not require hospitalization or institutionalization. Clinics, Free-Standing,Health Centers, Ambulatory,Outpatient Clinics,Abortion Centers,Abortion Clinics,Ambulatory Care Facilities, Non Hospital,Ambulatory Care Facilities, Non-Hospital,Ambulatory Care Facilities, Nonhospital,Clinic Activities,Family Planning Centers,Outpatient Clinic,Urgent Care Centers,Urgent Care Clinics,Abortion Center,Abortion Clinic,Activities, Clinic,Activity, Clinic,Ambulatory Care Facility,Ambulatory Health Center,Ambulatory Health Centers,Care Center, Urgent,Care Centers, Urgent,Care Clinic, Urgent,Care Clinics, Urgent,Center, Abortion,Center, Ambulatory Health,Center, Family Planning,Center, Urgent Care,Centers, Abortion,Centers, Ambulatory Health,Centers, Family Planning,Centers, Urgent Care,Clinic Activity,Clinic, Abortion,Clinic, Free-Standing,Clinic, Outpatient,Clinic, Urgent Care,Clinics, Abortion,Clinics, Free Standing,Clinics, Outpatient,Clinics, Urgent Care,Facilities, Ambulatory Care,Facility, Ambulatory Care,Family Planning Center,Free-Standing Clinic,Free-Standing Clinics,Health Center, Ambulatory,Urgent Care Center,Urgent Care Clinic
D001007 Anxiety Feelings or emotions of dread, apprehension, and impending disaster but not disabling as with ANXIETY DISORDERS. Angst,Anxiousness,Hypervigilance,Nervousness,Social Anxiety,Anxieties, Social,Anxiety, Social,Social Anxieties
D001524 Behavioral Medicine The interdisciplinary field concerned with the development and integration of behavioral and biomedical science, knowledge, and techniques relevant to health and illness and the application of this knowledge and these techniques to prevention, diagnosis, treatment, and rehabilitation. Health Psychology,Psychology, Health,Medicine, Behavioral,Health Psychologies,Psychologies, Health
D014861 Washington State bounded by on the north by Canada, on the east by Idaho, on the south by Oregon, and on the west by the Pacific Ocean.
D019033 Delivery of Health Care, Integrated A health care system which combines physicians, hospitals, and other medical services with a health plan to provide the complete spectrum of medical care for its customers. In a fully integrated system, the three key elements - physicians, hospital, and health plan membership - are in balance in terms of matching medical resources with the needs of purchasers and patients. (Coddington et al., Integrated Health Care: Reorganizing the Physician, Hospital and Health Plan Relationship, 1994, p7) Integrated Delivery Systems,Integrated Health Care Systems,Delivery System, Integrated,Delivery Systems, Integrated,Integrated Delivery System,System, Integrated Delivery,Systems, Integrated Delivery
D019982 Organizational Case Studies Descriptions and evaluations of specific health care organizations. Case Studies, Organizational,Management Case Studies,Case Studies, Management,Studies, Management Case,Studies, Organizational Case

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