"The majority of the research on collaborative care has been carried out with insured patient populations who have more resources and greater access to mental and physical health services than is typical of uninsured patient populations. Efforts to disseminate collaborative care have been undertaken by several large, resourced systems of care, including the Veterans Administration , Kaiser Permanente, and the Bureau of Primary Care's clinic system (Katon & Unu¨tzer, 2006). There have been a limited number of reports of collaborative care models that have been implemented in settings that serve low-income, uninsured populations (Little, 2009; Mauksch et al., 2007). "
[Show abstract][Hide abstract] ABSTRACT: Low-income, uninsured immigrants are burdened by poverty and a high prevalence of trauma exposure and thus are vulnerable to mental health problems. Disparities in access to mental health services highlight the importance of adapting evidence-based interventions in primary care settings that serve this population. In 2005, the Montgomery Cares Behavioral Health Program began adapting and implementing a collaborative care model for the treatment of depression and anxiety disorders in a network of primary care clinics that serve low-income, uninsured residents of Montgomery County, Maryland, the majority of whom are immigrants. In its 6th year now, the program has generated much needed knowledge about the adaptation of this evidence-based model. The current article describes the adaptations to the traditional collaborative care model that were necessitated by patient characteristics and the clinic environment.
American Journal of Orthopsychiatry 10/2011; 81(4):543-51. DOI:10.1111/j.1939-0025.2011.01125.x · 1.50 Impact Factor
"Hopefully the papers in this issue will advance both the conceptual and evidentiary clarity to inform what such a presence should look like and what it should do. However, we need to heed Katon and Unutzer's observation after reviewing the research evidence demonstrating the effectiveness of treating depression in primary care, that the findings are sufficiently compelling to suggest we should stop doing further research in the area and move to implementing the findings in general practice (Katon & Unutzer, 2006). So to start following their advice, here are the actions for the field that will allow that to happen. "
[Show abstract][Hide abstract] ABSTRACT: Psychology and other behavioral health professions have amassed a broad empirical and clinical literature suggesting many medical presentations are best responded to with the addition of evidence based behavioral interventions. Despite this, psychology has not achieved a regular presence as part of medical practice. We suggest specific reasons for the current state of affairs including clinical, operational, societal labels, financial and training dimensions. Medical, psychological, administrative, and financial perspectives are reviewed. If the goals of health care system reform are to be reached then we must identify and challenge the current limitations of health care. This paper will identify the elements that need to be changed in order for psychology to be integrated into medicine rather than excluded from its policy, planning and operations.
Journal of Clinical Psychology in Medical Settings 03/2009; 16(1):4-12. DOI:10.1007/s10880-009-9146-y · 1.49 Impact Factor
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