There is an integral link in treatments between mental health and physical health that encourage the treatment of mental health disorders in primary care settings, which reach the most patients. This is one of the most popular settings for people who could benefit from mental health services. This inclusive concept would require some changes in the system and pragmatism that would build on the strengths of both fields. There is a need for better treatment of mental disorders in primary care. This also brings a need for mental health professionals to be numerous enough to accept referrals.
To date, the list of barriers in treatment seems to be extensive. Symptoms can overlap in multiple categories of illness. Diagnoses are often entirely based on status examinations and histories. Sometimes, symptoms themselves discourage seeking help, as can be the case with depression. Limited capacities for providing evidence-based treatments and for mental health specialists also hinders the cause. Also, mental health problems must ‘compete for attention’ against other health problems that can seem more pressing.
There is evidence that an effective therapeutic alliance between mental health and primary care may be an important component for effective treatments. There are also a few fantastic strides being made on the way to improving partnerships in mental health and primary care. This includes systematic screenings, education and training, referral to specialists, tracking outcomes, and collaborative care models. Guidelines have been developed in treatment of common mental health conditions in primary care. The problem is further implementation with specialized practitioners and treatments. There is evidence that adherence to algorithms can improve outcomes compared with usual care in controlled settings with regard to psychiatry. One thing that is needed in the field are studies on the effect of treatment guidelines and the application of them. There are few that carefully outline, disprove, or prove the effects. Despite this, there has been a high interest in interventions that increase the role of mental health specialists in managing mental health disorders within primary care. Identification of systematic barriers to account for inconsistent measurable differences in patient outcomes is also important. Further research in identifying key components of the programs and the most effective ways to adapt and implement programs in health care settings is needed. Great collaborative care programs can even leave some patients without a complete remission, and further work could identify evidence-based ways of improving outcomes for all patients.
Reference
Thielke, Stephen, et al. “Integrating Mental Health and Primary Care.” Primary Care: Clinics in Office Practice, vol. 34, no. 3, Sept. 2007, pp. 571–592, https://doi.org/10.1016/j.pop.2007.05.007
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