Building Value-Added Teams to Care for Behavioral Health Needs in Primary Care

  • Anna D. H. Ratzliff
  • Catherine L. Christensen
  • Jürgen Unützer
Chapter

Abstract

Collaborative care has emerged as an evidence-based approach to care for patients with common mental health disorders such as depression or anxiety in primary care. To deliver successful collaborative care, a program must build a team with effective “shared workflows.” A psychiatrist functioning in a mental health leadership role may play an important role in the development, implementation, and ongoing improvement of a high-functioning collaborative care team. The process of building such a team involves several stages: leadership commitment, preparing for team building, developing a clear vision for the scope of the program, assessing current resources and workflows, conducting a gap assessment to identify staff and training needs, generating a collaborative care workflow, training staff, program launch, and supporting the ongoing quality improvement efforts of the team.

Keywords

Depression Stake 

References

  1. 1.
    Moussavi S, Chatterji S, Verdes E, Tandon A, Patel V, Ustun B. Depression, chronic diseases, and decrements in health: results from the World Health Surveys. Lancet. 2007;370(9590): 851–8. PubMed PMID: 17826170.PubMedCrossRefGoogle Scholar
  2. 2.
    Katon W, Ciechanowski P. Impact of major depression on chronic medical illness. J Psychosom Res. 2002;53(4):859–63. PubMed PMID: 12377294.PubMedCrossRefGoogle Scholar
  3. 3.
    Wang PS, Lane M, Olfson M, Pincus HA, Wells KB, Kessler RC. Twelve-month use of mental health services in the United States: results from the National Comorbidity Survey Replication. Arch Gen Psychiatry. 2005;62(6):629–40. PubMed PMID: 15939840.PubMedCrossRefGoogle Scholar
  4. 4.
    Thota AB, Sipe TA, Byard GJ, Zometa CS, Hahn RA, McKnight-Eily LR, 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. PubMed PMID: 22516495.PubMedCrossRefGoogle Scholar
  5. 5.
    Gilbody S, Bower P, Fletcher J, Richards D, Sutton AJ. Collaborative care for depression: a cumulative meta-analysis and review of longer-term outcomes. Arch Intern Med. 2006;166(21): 2314–21. PubMed PMID: 17130383.PubMedCrossRefGoogle Scholar
  6. 6.
    Archer J, Bower P, Gilbody S, Lovell K, Richards D, Gask L, et al. Collaborative care for depression and anxiety problems. Cochrane Database Syst Rev. 2012;10, CD006525. PubMed PMID: 23076925.PubMedGoogle Scholar
  7. 7.
    Wagner EH, Austin BT, Davis C, Hindmarsh M, Schaefer J, Bonomi A. Improving chronic illness care: translating evidence into action. Health Aff (Millwood). 2001;20(6):64–78. PubMed PMID: ISI: 000172297900010.CrossRefGoogle Scholar
  8. 8.
    U.S. Department of Health and Human Services. Mental health: a report of the surgeon general. Rockville, MD: U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services, NIMH; 1999.Google Scholar
  9. 9.
    New Freedom Commission on Mental Health. Achieving the promise: transforming mental health care in America. Final report. Rockville, MD: Department of Health and Human Services Pub No SMA-03-3832; 2003. Available from: http://www.mentalhealthcommission.gov/reports/finalreport/toc.html
  10. 10.
    National Registry of Evidence-based Programs and Practices (NREPP). IMPACT (Improving mood—promoting access to collaborative treatment) [website]. The Substance Abuse and Mental Health Services Administration (SAMHSA); 2012 [updated 2012 Jun 19; cited 2013 Mar 29]. Available from: http://www.nrepp.samhsa.gov/ViewIntervention.aspx?id=301
  11. 11.
    Katon W, Unützer J. Consultation psychiatry in the medical home and accountable care organizations: achieving the triple aim. Gen Hosp Psychiatry. 2011;33(4):305–10. PubMed PMID: 21762825.PubMedCentralPubMedCrossRefGoogle Scholar
  12. 12.
    Unutzer J, Katon W, Callahan CM, Williams Jr JW, Hunkeler E, Harpole L, et al. Collaborative-care management of late-life depression in the primary care setting. JAMA. 2002;288(22): 2836–45. PubMed PMID: 12472325.PubMedCrossRefGoogle Scholar
  13. 13.
    Lin EH, Tang L, Katon W, Hegel MT, Sullivan MD, Unutzer J. Arthritis pain and disability: response to collaborative depression care. Gen Hosp Psychiatry. 2006;28(6):482–6. PubMed PMID: 17088163.PubMedCrossRefGoogle Scholar
  14. 14.
    Unützer J, Katon WJ, Fan MY, Schoenbaum MC, Lin EH, Della Penna RD, et al. Long-term cost effects of collaborative care for late-life depression. Am J Manag Care. 2008;14(2): 95–100. PubMed PMID: 18269305.PubMedCentralPubMedGoogle Scholar
  15. 15.
    Uebelacker LA, Smith M, Lewis AW, Sasaki R, Miller IW. Treatment of depression in a low-income primary care setting with colocated mental health care. Fam Syst Health. 2009;27(2): 161–71. PubMed PMID: 19630457.PubMedCentralPubMedCrossRefGoogle Scholar
  16. 16.
    University of Washington. AIMS (Advancing Integrated Mental Health Solutions) Center [website]. Seattle, WA: University of Washington; 2013 [updated 2013 Mar 29; cited 2013 Mar 29].Google Scholar
  17. 17.
    Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001;16(9):606–13. PubMed PMID: 11556941.PubMedCentralPubMedCrossRefGoogle Scholar
  18. 18.
    Kathol RG, Butler M, McAlpine DD, Kane RL. Barriers to physical and mental condition integrated service delivery. Psychosom Med. 2010;72(6):511–8. PubMed PMID: 20498293.PubMedCrossRefGoogle Scholar
  19. 19.
    Wynia MK, Von Kohorn I, Mitchell PH. Challenges at the intersection of team-based and patient-centered health care: insights from an IOM working group. JAMA. 2012;308(13): 1327–8. PubMed PMID: 23032546.PubMedCrossRefGoogle Scholar
  20. 20.
    Sargeant J, Loney E, Murphy G. Effective interprofessional teams: “contact is not enough” to build a team. J Contin Educ Health Prof. 2008;28(4):228–34. PubMed PMID: 19058243.PubMedCrossRefGoogle Scholar
  21. 21.
    Shaw EK, Howard J, Etz RS, Hudson SV, Crabtree BF. How team-based reflection affects quality improvement implementation: a qualitative study. Qual Manag Health Care. 2012;21(2): 104–13. PubMed PMID: 22453821.PubMedCentralPubMedCrossRefGoogle Scholar
  22. 22.
    Varkey P, Reller MK, Resar RK. Basics of quality improvement in health care. Mayo Clin Proc. 2007;82(6):735–9. PubMed PMID: 17550754.PubMedCrossRefGoogle Scholar
  23. 23.
    Regier DA, Narrow WE, Rae DS, Manderscheid RW, Locke BZ, Goodwin FK. The de facto US mental and addictive disorders service system. Epidemiologic catchment area prospective 1-year prevalence rates of disorders and services. Arch Gen Psychiatry. 1993;50(2):85–94.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Anna D. H. Ratzliff
    • 1
  • Catherine L. Christensen
    • 1
  • Jürgen Unützer
    • 1
  1. 1.Department of Psychiatry and Behavioral SciencesUniversity of WashingtonSeattleUSA

Personalised recommendations