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Psychiatric Quarterly

, Volume 89, Issue 4, pp 897–908 | Cite as

Providing Mental Health Services in the Primary Care Setting: the Experiences and Perceptions of General Practitioners at a New York City Clinic

  • Issa Papiss BagayogoEmail author
  • Katharina Turcios-Wiswe
  • Kanako Taku
  • Lauren Peccoralo
  • Craig L. Katz
Original Paper

Abstract

Mental illness is a significant cause of disability worldwide, including here in the United States. Given the shortage of trained mental health professionals, a significant portion of patients needing care are managed in the primary care setting. Accountable Care Organizations (ACOs), for example, are seeking to improve the quality of care for this vulnerable population, but many are facing significant challenges relating to integration of new services. We sought to elucidate barriers faced by primary care practitioners (PCPs)—physicians, physician trainees and nurse practitioners—at a New York primary care clinic, which impede delivery of optimal care to those suffering from mental illness. The study was conducted with 32 PCPs in 2016–2017 at Mount Sinai Internal Medicine Associates in New York City. For the quantitative component of the study, a 54-item questionnaire was devised to assess their attitude, behavior and confidence in managing psychiatric patients. For the qualitative component, data was obtained from 3 open-ended questions. Responses were coded for salient themes. Analysis revealed a range of difficulties faced by PCPs. Overall, participants felt that the need to integrate mental health care into primary care was important, however they reported significant barriers in terms of lack of time, lack of resources, low confidence in treating more complex mental health conditions and difficulties with referring patient to mental health specialists. Despite a growing body of evidence that integration of mental health services in primary care leads to improved outcomes, addressing barriers to care will be key to ensuring feasibility of integration measures.

Keywords

Mental health services Integrated care Primary care Global health New York City Health policy 

Notes

Acknowledgements

We would like to thank all providers that took part in this study.

Mount Sinai Internal Medicine Associates.

Icahn School of Medicine at Mount Sinai (ISMMS).

Arnold Institute for Global Health-Global Mental Health Residency Track at ISMMS.

Mount Sinai Beth Israel Department of Psychiatry.

Compliance with Ethical Standards

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This study was determined to be exempt research by the Mount Sinai Program for the Protection of Human Subjects.

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Disclosures

This manuscript has not been previously published and is not under consideration in the same or substantially similar form in any other peer-reviewed media. All authors listed have contributed sufficiently to the project to be included as authors. To the best of our knowledge, no conflict of interest, financial or other, exists.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Mount Sinai Beth Israel Department of PsychiatryIcahn School of Medicine at Mount SinaiNew YorkUSA
  2. 2.Icahn School of Medicine at Mount SinaiOne Gustave L. Levy PlaceNew YorkUSA
  3. 3.Department of PsychologyOakland UniversityRochesterUSA
  4. 4.Department of Medicine, Division of General Internal MedicineIcahn School of Medicine at Mount SinaiNew YorkUSA
  5. 5.Department of Psychiatry and Department of Medical EducationIcahn School of Medicine at Mount SinaiNew YorkUSA

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