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Barriers and Enablers to Integrating Mental Health into Primary Care: A Policy Analysis

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Abstract

Integrating care for physical health and behavioural health (mental health and addictions) has been a longstanding challenge, although research supports the clinical and cost effectiveness of integrated care for many clients. In one such model, primary care (PC) physicians work with specialist physicians and non-physician providers (NPPs) to provide mental health and addictions care in PC settings. This Ontario, Canada-focused policy analysis draws on research evidence to examine potential barriers and enablers to this model of integrated care, focusing on mental health. Funding challenges pertain to incentivizing PC physicians to select patients with mental illness, include NPPs on the treatment team, and collaborate with specialist providers. Legal/regulatory challenges pertain to NPP scopes of practice for prescribing and counselling. Integrated care also requires revising the role of the physician and distribution of functions among the team. Policy support to integrate addictions treatment in PC may face similar challenges but requires further exploration.

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Acknowledgments

An earlier version of this paper won the Best Doctoral Submission for Canadian Association for Health Services and Policy Research (CAHSPR), 2011

Conflict of Interest

There were no financial or other relationships that might lead to a conflict, or perceived conflict, of interest.

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  1. Institute of Health Policy, Management and Evaluation, University of Toronto, 155 College Street, Suite 425, Toronto, Ontario, M5T 3M6, Canada

    Anna Durbin MPH, PhD candidate, Jennifer M. Hensel MD, MSc & Raisa Deber PhD

  2. Provincial System Support Program, Center for Addiction and Mental Health, 33 Russell Street, Toronto, Ontario, M5S 2S1, Canada

    Janet Durbin PhD

  3. Center for Addiction and Mental Health, 33 Russell Street, Toronto, Ontario, M5S 2S1, Canada

    Jennifer M. Hensel MD, MSc

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  1. Anna Durbin MPH, PhD candidate
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Correspondence to Anna Durbin MPH, PhD candidate.

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Durbin, A., Durbin, J., Hensel, J.M. et al. Barriers and Enablers to Integrating Mental Health into Primary Care: A Policy Analysis. J Behav Health Serv Res 43, 127–139 (2016). https://doi.org/10.1007/s11414-013-9359-6

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