Integrating Mental Health Services into a General Hospital in Puerto Rico
- 243 Downloads
The prevalence of mental health problems in the general population should be carefully considered. The literature has reported a high co-morbidity of medical and mental illnesses; therefore, collaborative efforts incorporating psychological services into medical settings are imperative. In Puerto Rico, this is not a regular practice in general hospitals. Improving access to mental health services is a challenge and requires the creation of new venues within the healthcare system. This paper describes the theoretical framework, mission, and objectives of the Clinical Psychology Services Program (CPSP) implemented at Damas Hospital in Puerto Rico. From December 2002 to December 2010, a total of 13,580 visits were made to inpatients in diverse clinical units of the hospital; 61 % of all inpatients evaluated met the criteria for at least one mental health disorder based on the DSM-IV-TR. The CPSP’s outcomes highlight the acceptance and relevance of incorporating mental health services and clinical psychologists into general hospitals.
KeywordsClinical Psychology Hospital Integrated Medical setting
The authors wish to thank doctoral students of the Clinical Psychology Program of the Ponce School of Medicine for their enthusiastic support and participation during these eight years. Also, thanks to the administrative staff and health care providers, especially physicians and nurses of the Damas Hospital at Ponce, Puerto Rico. Our special thanks to Dr. Javier Hernández, Dr. Nanet López, Dr. Mary Rodríguez, and Dr. Nydia Ortiz for your valuable support as clinical supervisors during the different stages of the Clinical Psychology Services Program development. Also, a special thanks to Mr. Bob Richie for assisting in the manuscript’s edition.
- Alegria, M., Canino, G., Shrout, P., Woo, M., Duan, N., Vila D.,…,Meng, X. (2008). Prevalence of mental health illness in immigrant and non-immigrant U.S. Latino groups. American Journal of Psychiatry, 165, 359–369.Google Scholar
- American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorder (revised 4th ed.). Washington, DC: American Psychiatric Association.Google Scholar
- Baca-García, E., Pérez, M., Basurte, I., Quintero, F., Sevilla, J., Martínez,…,González, J. (2008). Patterns of mental health service utilization in a general hospital and outpatient mental facilities: Analysis of 365,262 psychiatric consultations. European Archives of Psychiatry and Clinical Neuroscience, 258(2), 117–123.Google Scholar
- Canino, G., Bird, H., Rubio-Stipec, M., & Bravo, M. (2000). The epidemiology of mental health disorders in the adults population of Puerto Rico. Interamerican Journal of Psychology, 34, 29–46.Google Scholar
- Departamento de Salud del Estado Libre Asociado de Puerto Rico. (2004). Estadísticas vitales de Puerto Rico, 1990, 1991, 1992, 1993, 1994, 1995, 1996, 1997, 1998, 1999, 2000, 2001, 2002 [Vital statistics for Puerto Rico, 1990, 1991, 1992, 1993, 1994, 1995, 1996, 1997, 1998, 1999, 2000, 2001, 2002]. Secretaría Auxiliar de Planificación, Evaluación Estadística y Sistemas de Información. San Juan, Puerto Rico: Departamento de Salud.Google Scholar
- Departamento de Salud del Estado Libre Asociado de Puerto Rico. (2004). Análisis del sector de salud [Analysis for the health sector]. San Juan, Puerto Rico: Departamento de Salud de Puerto Rico. Retrieved from http://tendenciaspr.uprrp.edu/salud/informe_salud/Analisis_sectorial_PR_final.doc.
- Gonick, U., Farrow, I., Meier, M., Ostmand, G., & Frolick, L. (1981). Cost effectiveness of behavioral medicine procedures in the treatment of stress-related disorders. American Journal of Clinical Biofeedback, 4, 16–24.Google Scholar
- Hämäläinen, J., Isometsa, E., Laukkala, T., Kapiro, J., Poikolainen, K., Heikkinen,…,Aro, H. (2004). Use of health services for major depressive episode in Finland. Journal of Affective Disorders, 79, 105–112.Google Scholar
- Heidenreich, P., Trogdon, J., Khavjou, O., Butler, J., Dracup, K., Ezekowitz, M.,…,Woo, Y. J. (2011). Forecasting the future of cardiovascular disease in the United States: A policy statement from the American Heart Association. Circulation, 123, 933–944.Google Scholar
- Hunsley, J. (2002). The cost-effectiveness of psychological interventions. Ottawa, ON: Canadian Psychological Association.Google Scholar
- Levitan, S., & Kornfeld, D. (1981). Clinical and cost benefits of liaison psychiatry. The American Journal of Psychiatry, 139, 790–793.Google Scholar
- National Alliance on Mental Illness. (July, 2004). Cumbre Multisectorial de Salud Mental, Puerto Rico 2004 [Multisector Mental Health Summit]. San Juan, Puerto Rico: National Alliance on Mental Illness (NAMI-PR).Google Scholar
- Schlesinger, H., Mumford, E., Glass, G. V., Patrick, C., & Sharfstein, S. (1983). Mental health treatment and medical care utilization in a fee-for-service system: Outpatient mental health treatment following the onset of a chronic disease. American Journal of Public Health, 73, 422–429.PubMedCrossRefGoogle Scholar
- Seltzer, A. (1989). Prevalence, detection and referral of psychiatric morbidity in general medical patients. Journal of the Royal Society Medicine, 82, 410–412.Google Scholar
- Simon, G., Katon, W., Lin, E., Rutter, C., Manning, W., Von Korff, M.,…,Young, B. (2007). Cost-effectiveness of systematic depression treatment among people with diabetes mellitus. Archives of Geneneral Psychiatry, 64, 65–72.Google Scholar
- U.S. Census Bureau. (2000). Puerto Rico Census. Washington, D.C. Retrieved from http://www.census.gov.