Journal of Community Health

, Volume 30, Issue 2, pp 125–140 | Cite as

Psychosocial Problems among Patients in Neighborhood Health Centers: Perspectives from Health Care Providers

  • Victoria M. Rizzo
  • Terry Mizrahi
  • Kristen Kirkland
Article

Abstract

Little is known about how health care professionals perceive and understand the psychosocial problems of individuals receiving services in neighborhood health centers (NHCs). We conducted interviews with health care professionals in NHCs in New York City. The respondents identified seven problems, including a lack of financial resources, unsafe housing, and emotional distress/depression as affecting large portions of their patient populations. Respondents reported that they are presently meeting many of the psychosocial needs of their clients, but they were pessimistic about their ability to continue to do so due to a lack of funding streams to support their provision of comprehensive health care that includes psychosocial services. The findings suggest that while NHCs may be “holding their own” in providing quality services to their clients, this will be harder to sustain in the future if the numbers of the uninsured served continues to increase, and the revenues generated continue to decrease.

Keywords

psychosocial problems neighborhood health centers primary care community health centers community-based health services 
This is a preview of subscription content, log in to check access.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Institute of Medicine2000America’s Health Care Safety Net: Intact But EndangeredNational Academy of SciencesWashington, DCGoogle Scholar
  2. Davis SK, Collins KS. Community Health Centers in a Changing U.S. Health Care System; 1999Google Scholar
  3. Geldberg, L, Gallagher, TC, Anderson, RM, Koegel, P. 1997Competing priorities as a barrier to medical care among homeless adults in Los AngelesAm J Public Health87217220Google Scholar
  4. Fillenbaum, G, Horner, R, Hanlon, D, Landerman, L, Dawson, D, Cohen, H. 1996Factors predicting change in prescription and nonprescription drug use in community-residing black and white elderly populationJ Clin Epidemiol49587593Google Scholar
  5. Kutner, N. 2001Improving compliance in dialysis patients: Does anything work?Semin Dial14324327Google Scholar
  6. Rubin, R, Petrot, M. 1992Psychosocial problems and interventions in diabetesDiabetes Care1516401657PubMedGoogle Scholar
  7. Berkman, B. 1996The emerging health care world: Implications for social work practice and educationSoc Work41541551Google Scholar
  8. Netting, FE, Williams, F. 1998Can we prepare geriatric social workers to collaborate in primary care practices?J Soc Work Educ34195210Google Scholar
  9. Tirrito, IN, Langer, N. 1996Elder Practice: A Multidisciplinary Approach to Working with Older Adults in the CommunityUniversity of South Carolina PressColumbia, SCGoogle Scholar
  10. McGrath, P. 1999Update on psychosocial research on leukaemia for social work practitionersSoc Work Health Care29120Google Scholar
  11. Rich, M, Beckham, V, Wittenberg, C, Leven, C, Freedland, K, Carney, R. 1995A multidisciplinary intervention to prevent the readmission of elderly patients with congestive heart failureN Engl J Med33311901195Google Scholar
  12. Claiborne, N, Vandenburgh, H. 2001Social workers’ role in disease managementHealth Soc Work26217225Google Scholar
  13. Rabkin, J, Balassone, M, Bell, M. 1995The role of social workers in providing comprehensive health care to pregnant womenSoc Work Health Care208397Google Scholar
  14. Perloff, J. 1996Medicaid managed care and urban poor people: implications for social workHealth Soc Work21189195Google Scholar
  15. Margolis, P, Lannon, C, Stevens, R,  et al. 1996Linking clinical and public health approaches to improve access to health care for socially disadvantaged mothers and childrenArch Pediatr Adolesc Med150815821Google Scholar
  16. Francouer, R, Copley, C, Miller, P. 1997The challenge to meet the mental health and biopsychosocial needs of the poor: Expanded roles for hospital social workers in a changing health care environmentSoc Work Health Care26113Google Scholar
  17. Joint Commission on Accreditation of Health Care Organizations. The Chronic Care Model: Model Components . http://www.improvingchroniccare.org/change/model/components.html, 2003Google Scholar
  18. Haizlip J. Disease management expands home care opportunities. The Remington Report 2002:10–13Google Scholar
  19. Cohen, S, Underwood, L, Benjamin, G. 2000Social Support Measurement and InterventionOxford University PressNew YorkGoogle Scholar
  20. Anderson, RM. 1995Revisiting the behavioral model and access to medical care: Does it matter?J Health Soc Behav36110Google Scholar
  21. Badger, LW, Ackerson, B, Buttell, F, Rand, EH. 1997The case for integration of social work psychosocial services into rural primary care practiceHealth Soc Work222029Google Scholar
  22. Callahan, E, Bertakis, K, Azari, R, Robbins, J, Helms, LJ, Miller, J. 1996The influence of depression on physician-patient interaction in primary careFam Med28346351Google Scholar
  23. Campbell, T, Franks, P, Fiscella, K,  et al. 2000Do physicians who diagnose more mental health disorders generate lower health care costs?J Fam Pract49305310Google Scholar
  24. Gross, R, Rabinowitz, J, Feldman, D, Boerma, W. 1996Primary health care physicians’ treatment of psychosocial problems: Implications for social workHealth Soc Work218995Google Scholar
  25. Scheff, R, Rand, W, Paterson, JC, Ellis, G, Weeks, S. 1994Psychosocial problems in primary care: Pilot study of a new taxonomyJ Fam Pract38393399Google Scholar
  26. Wissow L, Roter D, Larson S, et al. Mechanisms behind the failure of residents’ longitudinal primary care to promote disclosure and discussion of psychosocial issues. Arch Pediatr Adolesc Med 2002; 156Google Scholar
  27. Siegler, E, Hyer, K. 1998Geriatric Interdisciplinary Team TrainingSpringerNew YorkGoogle Scholar
  28. Thomas, CP, Payne, SM 1999Home alone: Unmet needs for formal support services among home health clientsHome Health Care Serv Q17120Google Scholar
  29. Cooksey, J, Danzinger, L, Ervin, N, Groves, S, Tyska, C, Kirk, G 1995Problem-based learning in an interdisciplinary community-based primary care courseTeach Learn Med7241245Google Scholar
  30. Carlton, W 1977The health team training model: A teaching-learning approach in community healthHealth Monographs56274Google Scholar
  31. Berkman, B, Shearer, S, Simmons, WJ,  et al. 1996Ambulatory elderly patients of primary care physicians: functional, psychosocial and environmental predictors of need for social work care managementSoc Work Health Care22121Google Scholar
  32. Pilossoph-Gelb, S, Mower, WR, Ajaelo, I, Yang, SC 1997Psychosocial difficulties and emergency department useAcad Emerg Med4589592Google Scholar
  33. Shearer, S, Simmons, J, White, M, Berkman, B 1995Physician partnership project: social work case managers in primary careContinuum15110Google Scholar
  34. Center for Work Force Studies2000Support and Social Services Provided by Managed Care Plans in New York State: A Study Prepared for the New York State Department of Health, Office of Managed CareUniversity at AlbanySchool of Public HealthGoogle Scholar
  35. Friedmann, P, D’Aunno, T, Jin, L, Alexander, J 2000Medical and psychosocial services in drug abuse treatment: Do stronger linkages promote client utilization?Health Serv Res35443465Google Scholar
  36. Perloff JD, Rizzo VM. Social Work Services in Community-based Health Care Settings: Inroads and Impediments. American Public Health Association 127th Annual Meeting. Chicago, IL. 1999.Google Scholar
  37. Young-Pistella, C, Bonati, F, Mihalic, S 2000Rural women’s health perceptions of community prenatal care systems: An empowerment strategyJ Health Soc Policy117587Google Scholar
  38. Weiss, E, Haslanger, K, Cantor, J 2001Accessibility of primary care services in safety net clinics in New York CityAm J Public Health9112401245Google Scholar
  39. Mullan, P, Stross, J 1990Sensitivity to patients’ psychosocial concerns: Relationships among ratings by primary care and traditional internal medicine house officers and patient self-assessmentsSoc Sci Med3113371345Google Scholar
  40. Egan, M, Kadushin, G 1997Rural hospital social work: Views of physicians and social workersSoc Work Health Care26124Google Scholar
  41. United Hospital Fund1999Enabling services at ambulatory care sites: Trends and outlookCurr Medicaid Managed Care413Google Scholar
  42. Corbin, J, Strauss, A 1990Grounded theory research: Procedures, canons, and evaluative criteriaQualitative Sociol13321Google Scholar
  43. Glaser, B, Strauss, A 1967The Discovery of Grounded TheoryAldineChicagoGoogle Scholar
  44. Dobrof J, Umpierre M, Rocha L, Silverton M. Group work in a primary care setting. Health Soc Work (1990) February:32–37.Google Scholar
  45. Jackson, J, Kroenke, K 1999Difficult patient encounters in the ambulatory clinic: Clinical predictors and outcomesArch Intern Med15910691075Google Scholar
  46. Rosenbach, M, Young, C 2000Care Coordination in Medicaid Managed Care: A Primer for States, Managed Care Organizations, Providers, and AdvocatesCenter for Health Care Strategies, Inc.Princeton, NJGoogle Scholar
  47. Bureau of Primary Health CareDivision of Community and Migrant HealthUnited States Department of Health and Human Services.2001Community and Migrant Health Centers: Experts with Experience 1990–2000Government Printing OfficeRockville (MD)Google Scholar
  48. Dailard, C 2001Community Health Centers and Family Planning: What We KnowGuttmacher Report on Public PolicyWashington, DCGoogle Scholar
  49. Gusmano, M, Fairbrother, G, Park, H 2002From the field: Exploring the limits of the safety net: Community health centers and care for the uninsuredHealth Aff (Millwood)21188194Google Scholar
  50. Health Resources & Services Administration, United States Department of Health and Human Services. President Bush’s Fiscal Year 2004 Budget Proposal for HRSA. vol. 2003: http://newsroom.hrsa.gov/features/HRSA-FY04-proposed-budget-htm, 2003.Google Scholar

Copyright information

© Springer Science+Business Media, Inc. 2005

Authors and Affiliations

  • Victoria M. Rizzo
    • 1
  • Terry Mizrahi
    • 2
  • Kristen Kirkland
    • 3
  1. 1.School of Social WelfareUniversity at Albany, State University of New YorkAlbany
  2. 2.Hunter College of Social Work
  3. 3.Center for Excellence in Aging Services, School of Social WelfareUniversity at Albany, State University of New YorkAlbanyUSA

Personalised recommendations