The Next Step in Integrated Care: Universal Primary Mental Health Providers
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The Next Step in Integrated Care: Universal Primary Mental Health Providers Adrienne A. Williams1
© Springer Science+Business Media, LLC, part of Springer Nature 2019
Abstract Current models of mental health care often do not address three barriers to mental health: the binary view of mental illness (healthy vs. mentally ill), stigma, and prevention. Care models where some patients are selected for referral or consultation with a mental health professional can reinforce this binary view and the stigma associated with seeing mental health services. By only selecting patients who currently are experiencing mental health problems, current integrated care models do not offer sufficient avenues for prevention. To address these barriers, this article proposes building on current models through the development of primary mental health providers (PMHPs). PMHPs—like primary care providers—would provide regular check-ups, assessments, prevention interventions, first-line treatment, or referral to more specialized professionals. This universal approach will help decrease the binary view of mental health, decrease the stigma of seeing a mental health professional through universal access, and improve prevention efforts. Keywords Integrated care · Mental health · Prevention · Stigma · Behavioral health The spring 2018 special issue of Journal of Clinical Psychology in Medicals Settings on “The Primary Care Behavioral Health Model of Integration” featured articles summarizing the Primary Care Behavioral Health (PCBH) model and research surrounding it (Hunter, Reiter, & Dobmeyer, 2018). The PCBH model expands on other integrated models—such as Screening, Brief Intervention and Referral to Treatment (SBIRT), which focuses on substance use (Babor et al., 2007); and the Collaborative Care Model, which focuses on depression and anxiety (Hunter, Dobmeyer, & Reiter, 2018)—to reach a wider range of patients and conditions. However, the PCBH model and other integrated care models maintain some fundamental elements of mental health care models that continue to serve as barriers to population mental health. This article highlights how current integrated care models can maintain several fundamental barriers to mental health, and proposes steps to build on current integrated care models to address these barriers.
* Adrienne A. Williams [email protected] 1
Department of Family Medicine, University of Illinois at Chicago College of Medicine, 1919 W Taylor St., MCC 663, Chicago, IL 60612, USA
Current Integrated Care Models Current integrated care models, such as those described in the spring 2018 special issue of Journal of Clinical Psychology in Medicals Settings (Hunter et al., 2018) and the May–June 2014 special issue of American Psychologist (Anderson, 2014) share the idea that there is a significant subset of patients who present to physical health care providers who could benefit from also meeting with a mental health professional (MHP), and having a psychologist or other MHP to collaborate in care would improve health outcomes for t
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