The 130th Annual Meeting of APHA

Abstract #44283

William E. Aaronson, PhD, Dept of Risk, Insurance & Healthcare Management, Temple University, Ritter Annex (004-00), 1301 Cecil B. Moore Avenue, Philadelphia, PA 19122, 215.204.8128, waaron@sbm.temple.edu, Aurelia Nicoletta Bizamcer, MD, MPH, Dept. of Risk, Insurance & Healthcare Management, Temple University, 406 Ritter Annex (004-00), 1301 Cecil B. Moore Avenue, Philadelphia, PA 19122, and Kathryn Healey, PhD, Institute for Graduate Clinical Psychology, Widener University, One University Place, Chester, PA 19013.

In former Soviet countries persons affected by mental disorders have tended to avoid the psychiatric system because of the stigma attached to it. Primary mental disorders are not managed effectively in either the mental health or medical systems. With the assistance of US Agency for International Development and the American International Health Alliance, the authors participated in a demonstration of the use of a collaborative multidisciplinary team model to integrate primary mental health services into a family medicine primary care clinic. This paper presents the results of an ongoing evaluation of the project. We used a triangulation approach that involved a review of mental health referral patterns and a series of interview surveys with family physicians, nurses, mental health providers, and selected patients regarding the quality of collaboration between medical and mental health providers. A baseline survey was completed in September 2000; evaluation surveys completed in February and July 2001, and January 2002. Results are presented in the context of organizational change and team development theory and suggest that the traditional approach to physician-driven healthcare delivery is difficult to overcome. Training was needed in areas such as clinical supervision of the mental health team, interdisciplinary communication and team-based decision-making. When the family physicians understood and participated collaboratively, the mental health team became inundated with referrals and the staff had to be enlarged to accommodate. We identify the barriers and facilitators to implementation and which have important implications for integration of mental health services into primary care according to WHO guidelines.

Learning Objectives: At the conclusion of the session, the participant in this session will be able to

• Describe a model of integration of primary mental health services in a primary care clinic
• Analyze the barriers and facilitators to team development in a traditional medical setting
• Identify training needs of the team and methods to increase awareness and trust of other professionals represented on the team
• Discuss the role of clinical supervision of the mental health team and bridge activities such as case conferencing in building collaboration with physicians.
• Priortize 5 identified strategies to increase collaboration among the interdisciplinary team and to increase referrals for mental health services by physicians

Keywords: Community-Oriented Primary Care, Mental Health Services

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: American International Health Alliance US Agency for International Development
I have a significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
Relationship: 3.5 year, $945,000 grant