Skip to main content

Advertisement

SpringerLink
Log in

Teaching Psychiatry Residents to Work at the Interface of Mental Health and Primary Care

  • In Depth Article: Commentary
  • Published:
Academic Psychiatry Aims and scope Submit manuscript

Abstract

The authors present examples of programs educating psychiatry residents to work in integrated healthcare settings.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Wang PS, Lane M, Olfson M, et al. Twelve-month use of mental health services in the United States: results from the national comorbidity study replication. Arch Gen Psychiatry. 2005;62:629–40.

    Article  PubMed  Google Scholar 

  2. Spitzer RL, Kroenke K, Williams JB. Validation and utility of a self-report version of PRIME-MD: the PHQ primary care study primary care evaluation of mental disorders patient health questionnaire. JAMA. 1999;282:1737–44.

    Article  CAS  PubMed  Google Scholar 

  3. Mauksch LB, Tucker SM, Katon WJ, et al. Mental illness, functional impairment, and patient preferences for collaborative care in an uninsured, primary care population. J Fam Pract. 2001;50:41–7.

    CAS  PubMed  Google Scholar 

  4. Druss BG, Zhao L, Von Esenwein S, et al. Understanding excess mortality in persons with mental illness: 17-year follow up of a nationally representative US survey. Med Care. 2011;49:599–604.

    Article  PubMed  Google Scholar 

  5. Simon G, Ormel J, VonKorff M, Barlow W. Health care costs associated with depressive and anxiety disorders in primary care. Am J Psychiatry. 1995;152:352–7.

    CAS  PubMed  Google Scholar 

  6. Katon W, VonKorff M, Lin E, et al. A randomized trial of psychiatric consultation with distressed high utilizers. Gen Hosp Psychiatry. 1992;14:86–98.

    Article  CAS  PubMed  Google Scholar 

  7. Katon W, Gonzales J. A review of randomized trials of psychiatric consultation-liaison studies in primary care. Psychosomatics. 1994;35:268–78.

    Article  CAS  PubMed  Google Scholar 

  8. Valenstein M, Kales H, Mellow A, et al. Psychiatric diagnosis and intervention in older and younger patients in a primary care clinic: effect of a screening and diagnostic instrument. J Am Geriatr Soc. 1998;46:1499–505.

    CAS  PubMed  Google Scholar 

  9. Grembowski DE, Martin D, Patrick DL, et al. Managed care, access to mental health specialists, and outcomes among primary care patients with depressive symptoms. J Gen Intern Med. 2002;17(4):258–69.

    Article  PubMed Central  PubMed  Google Scholar 

  10. Bowling A, Bond M. A national evaluation of specialists’ clinics in primary care settings. Br J Gen Pract. 2001;51:264–9.

    CAS  PubMed Central  PubMed  Google Scholar 

  11. Gruen RL, Weeramanthri TS, Knight SS, Bailie RS. Specialist outreach clinics in primary care and rural hospital settings. Cochrane Database of Systematic Reviews 2003, Issue 4. Art. No.: CD003798. doi: 10.1002/14651858.CD003798.pub2.

  12. Van der Feltz-Cornelis CM, Van Os TWDP, Van Marwijk HWJ, Leentjens AFG. Effect of psychiatric consultation models in primary care. A systematic review and meta-analysis of randomized clinical trials. J Psychosomatic Research. 2010;68:521–33.

    Article  Google Scholar 

  13. Thota AB, Sipe TA, Byard GJ, et al. Collaborative care to improve the management of depressive disorders: a community guide systematic review and meta-analysis. Am J Prev Med. 2012;42(5):525–38.

    Article  PubMed  Google Scholar 

  14. Barry CL, Huskamp HA. Moving beyond parity—mental health and addiction care under the ACA. New Engl J Med. 2011;365:973–5.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  15. Croghan TW, Brown JD. Integrating mental health treatment into the patient centered medical home. Rockville, MD: Agency for Healthcare Research and Quality; 2010. (Prepared by Mathematica Policy Research under Contract No. HHSA290200900019I TO2.) AHRQ Publication No. 10-0084-EF.

    Google Scholar 

  16. Katon W, Unutzer J. Consultation psychiatry in the medical home and accountable care organizations: achieving the triple aim. Gen Hosp Psychiatry. 2011;33:305–10.

    Article  PubMed Central  PubMed  Google Scholar 

  17. Druss BG, Rohrbaugh RM, Levinson CM, Rosenheck RA. Integrated medical care for psychiatric patients with serious psychiatric illness: a randomized trial. Arch Gen Psychiatry. 2001;58(9):861–8.

    Article  CAS  PubMed  Google Scholar 

  18. Scharf DM, Eberhart NK, Schmidt N, et al. Integrating primary care into community behavioral health settings: programs and early implementation experiences. Psychiatric Services in Advance. 2013. doi:10.1176/appi.ps.201200269.

    Google Scholar 

  19. Peek CJ, National Integration Academy Council. Executive summary—lexicon for behavioral health and primary care integration: concepts and definitions developed by expert consensus. AHRQ publication no.13-IP001-1-EF. Rockville, MD: Agency for Healthcare Research and Quality; 2013. Available at: http://integrationacademy.ahrq.gov/sites/default/files/Lexicon_ExecSummary.pdf.

    Google Scholar 

  20. Heath B, Wise Romero P, Reynolds K. A standard framework for levels of integrated healthcare. Washington D.C.: SAMHSA-HRSA Center for Integrated Health Solutions; 2013.

    Google Scholar 

  21. Bell AC, D’Zurilla TJ. Problem-solving therapy for depression: a meta-analysis. Clin Psychol Rev. 2009;29:348–53.

    Article  PubMed  Google Scholar 

  22. Roy-Byrne P, Craske MG, Sullivan G, et al. Delivery of evidence-based treatment for multiple anxiety disorders in primary care: a randomized controlled trial. JAMA. 2010;303(19):1921–8.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  23. Barsky AJ, Ahern DK, Bauer MR, et al. A randomized trial of treatments for high-utilizing somatizing patients. J Gen Intern Med. 2013. doi:10.1007/S11606-013-2392-6.

    PubMed  Google Scholar 

  24. Gros DF, Haren WB. Open trial of brief behavioral activation psychotherapy for depression in an integrated veterans affairs primary care setting. Prim Care Companion CNS Disord. 2011;13(4). Pii: PCC.11m01136. doi: 10.4088/PCC.11m01136.

  25. Wissow L, Anthony B, Brown J, et al. A common factors approach to improving the mental health capacity of pediatric primary care. Adm Policy Ment Health. 2008;35:305–18.

    Article  PubMed Central  PubMed  Google Scholar 

  26. Noordman J, van der Weijden T, van Dulmen S. Communication-related behavior change techniques used in face-to-face lifestyle interventions in primary care: a systematic review of the literature. Patient Educ Couns. 2012;89:227–44.

    Article  PubMed  Google Scholar 

  27. Schuyler D, Davis K. Primary care and psychiatry: anticipating an interfaith marriage. Acad Med. 1999;74:27–32.

    Article  CAS  PubMed  Google Scholar 

  28. Brown HN, Zinberg NE. Difficulties in the integration of psychological and medical practices. Am J Psychiatry. 1982;139:1576–80.

    CAS  PubMed  Google Scholar 

  29. Cowley DS, Katon W, Veith RC. Training psychiatry residents as consultants in primary care settings. Academic Psychiatry. 2000;24:124–32.

    Article  Google Scholar 

  30. Yudkowsky R. So you want to train psychiatry residents in ambulatory primary care settings: a primer and guide for program directors. Academic Psychiatry. 2000;24(3):133–8.

    Article  Google Scholar 

  31. McCarron RM, Xiong GL, Bourgeois JA. Lippincott’s Primary Care Psychiatry. Lippincott, Williams & Wilkins. 2009 PSYCHIATRYFORPCP.COM (Companion web site)

  32. Ratzliff A, Basinski J. Collaborative care consultation psychiatry: a clinical rotation curriculum for psychiatry residents. 2013; http://uwaims.org/training-consulting_psychiatrists.html and http://uwaims.org/files/consulting_psychiatrist/residents/summary_overview_resident_curriculum.pdf

  33. Snyder K, Dobscha SK, Ganzini L, et al. Clinical outcomes of integrated psychiatric and general medical care. Community Ment Health J. 2008;44:147–54.

    Article  PubMed  Google Scholar 

  34. Dobscha SK, Snyder K, Corson K, Ganzini L. Psychiatry resident graduate comfort with general medical issues: impact of an integrated psychiatry-primary medical care training track. Academic Psychiatry. 2005;29:448–51.

    Article  PubMed  Google Scholar 

  35. Rohrbaugh RM, Felker B, Kosten T. The VA psychiatry-primary care education initiative. Academic Psychiatry. 2009;33(1):31–6.

    Article  PubMed  Google Scholar 

  36. Rubin EH, Zorumski CF. Upcoming paradigm shifts for psychiatry in clinical care, research, and education. Acad Med. 2012;87:261–5.

    Article  PubMed  Google Scholar 

  37. Kates N. Sharing mental health care: training psychiatry residents to work with primary care physicians. Psychosomatics. 2000;41:53–7.

    Article  CAS  PubMed  Google Scholar 

  38. Wright MT. Training psychiatrists in nonpsychiatric medicine: what do our patients and our profession need? Academic Psychiatry. 2009;33(3):181–6.

    Article  PubMed  Google Scholar 

Download references

Disclosures

Dr. Cowley is paid as an Associate Editor for Journal Watch Psychiatry (less than $3,000/year). Part of Dr. Ratzliff’s salary is paid by contract with the Community Health Plan of Washington, which provides collaborative care services through the Mental Health Integration Program. The other authors have no disclosures.

Author information

Authors and Affiliations

  1. University of Washington, Seattle, WA, USA

    Deborah Cowley, Anna Ratzliff & Jurgen Unutzer

  2. Oregon Health and Science University, Portland, OR, USA

    Kristen Dunaway

  3. Harvard Medical School, Cambridge, MA, USA

    Marshall Forstein

  4. Johns Hopkins, Baltimore, MD, USA

    Emily Frosch & Barry Solomon

  5. UC Davis, Sacramento, CA, USA

    Jaesu Han & Robert M. McCarron

  6. Cambridge Health Alliance, Cambridge, MA, USA

    Robert Joseph

Authors
  1. Deborah Cowley
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kristen Dunaway
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Marshall Forstein
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Emily Frosch
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Jaesu Han
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Robert Joseph
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Robert M. McCarron
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Anna Ratzliff
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Barry Solomon
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Jurgen Unutzer
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Deborah Cowley.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Cowley, D., Dunaway, K., Forstein, M. et al. Teaching Psychiatry Residents to Work at the Interface of Mental Health and Primary Care. Acad Psychiatry 38, 398–404 (2014). https://doi.org/10.1007/s40596-014-0081-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40596-014-0081-3

Keywords

Search

Navigation