Abstract
An international group of clinicians and researchers formed a consortium to advance mental and social health among people seeking musculoskeletal specialty care: The International Consortium for Mental and Social Health in Musculoskeletal Care (I-MESH). As a first step to organize the work of the consortium, we sought to identify important, appropriate, and feasible interventions to address mental and social health. Members of I-MESH responded to a list of 10 queries intended to elicit mental and social health priorities. Open text answers were analyzed by 2 researchers to elicit individual themes. A modified RAND/UCLA Delphi Appropriateness process was conducted of 32 candidate social and mental health priorities using a 15-person panel of I-MESH members, using 2 rounds of independent voting with intervening discussion via surveys and video teleconferences. Panelists rated each potential priority for importance, feasibility, and appropriateness on a 9-point Likert scale. Top level priorities scored both mean and median greater than 7 in all 3 categories. Second level priorities scored a median 7 or greater on the final scoring in all 3 categories. Candidate priorities were organized into 9 themes: viable business model, coordination of specialty and non-specialty care, actionable measurement, public health/cultural interventions, research, adequate and timely access, incorporating assessment in care, strategies to develop the patient-clinician relationship, communication strategies that can directly enhance health, and support for mental and social health. Twelve top level (met mean and median criteria) and 17 s level priorities (met median criterion) were identified. Implementing evidence-based strategies to efficiently diagnose, prioritize, and begin addressing mental and social health opportunities has the potential for notable impact on both musculoskeletal and overall health. It is our hope that the results of this Delphi panel will generate enthusiasm and collaboration for implementing the mounting evidence that social and mental health are integral to musculoskeletal health.
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Appendix: Round 1: Open Text Survey
Appendix: Round 1: Open Text Survey
1. Please provide as many suggestions as you can think of for improving musculoskeletal health in general, and the mental and social components of health in particular.
2. Please provide as many suggestions as you can to improve the way we measure mental aspects of musculoskeletal health.
3. Please provide as many suggestions as you can to improve the way we measure social aspects of musculoskeletal health.
4. Please provide as many suggestions as you can to further the development of new tools or interventions to advance mental aspects of musculoskeletal health.
5. Please provide as many suggestions as you can to further the development of new tools or interventions to advance social aspects of musculoskeletal health.
6. What are the potential barriers to the improvement of mental and social care for patients with musculoskeletal illness?
7. What are the potential barriers to the improvement of mental health for patients with musculoskeletal illness?
8. What are the potential facilitators of improvement of mental health among people with musculoskeletal symptoms?
9. What are the potential barriers to the improvement of social health for patients with musculoskeletal illness?
10. What are the potential facilitators of improvement of social health among people with musculoskeletal symptoms?
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Ring, D. Priorities for Advancing Mental and Social Health Among People Presenting for Care of Musculoskeletal Symptoms. J Clin Psychol Med Settings 30, 197–203 (2023). https://doi.org/10.1007/s10880-022-09865-w
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DOI: https://doi.org/10.1007/s10880-022-09865-w