Abstract
Objective
With the increased implementation of models that integrate behavioral health with other medical care, there is a need for a workforce of integrated care providers, including psychiatrists, who are trained to deliver mental health care in new ways and meet the needs of a primary care population. However, little is known about the educational needs of psychiatrists in practice delivering integrated care to inform the development of integrated care training experiences.
Method
The educational needs of the integrated care team were assessed by surveying psychiatric consultants who work in integrated care.
Results
A convenience sample of 52 psychiatrists working in integrated care responded to the survey. The majority of the topics included in the survey were considered educational priorities (>50 % of the psychiatrists rated them as essential) for the psychiatric consultant role. Psychiatrists’ perspectives on educational priorities for behavioral health providers (BHPs) and primary care providers (PCPs) were also identified. Almost all psychiatrists reported that they provide educational support for PCPs and BHPs (for PCP 92 %; for BHP 96 %).
Conclusions
The information provided in this report suggests likely educational needs of the integrated care psychiatric consultant and provides insight into the learning needs of other integrated care team members. Defining clear priorities related to the three roles of the integrated care psychiatric consultant (clinical consultant, clinical educator, and clinical team leader) will be helpful to inform residency training programs to prepare psychiatrists for work in this emerging field of psychiatry.
References
Archer J, Bower P, Gilbody S, Lovell K, Richard D, Gask L, et al. Collaborative care for depression and anxiety problems. Cochrane Database Syst Rev. 2012. doi:10.1002/14651858.CD006525.pub2.
Huffman JC, Niazi SK, Rundell JR, Sharpe M, Katon WJ. Essential articles on collaborative care models for the treatment of psychiatric disorders in medical settings: a publication by the Academy of Psychosomatic Medicine Research and Evidence-Based Practice Committee. Psychosomatics. 2014. doi:10.1016/j.psym.2013.09.002.
Raney L. Integrated care: the evolving role of psychiatry in the era of health care reform. Psychiatr Serv. 2013. doi:10.1176/appi.ps.201300311.
Rush AJ. STAR*D: what have we learned? Am J Psychiatry. 2007;164:201–4.
Thielke S, Vannoy S, Unützer J. Integrating mental health and primary care. Prim Care. 2007;34:571–92.
Katon W, Unützer J. Consultation psychiatry in the medical home and accountable care organizations: achieving the triple aim. Gen Hosp Psychiatry. 2011. doi:10.1016/j.genhosppsych.2011.05.011.
Cowley D, Dunaway K, Forstein M, Frosch E, Han J, Joseph R, et al. Teaching psychiatry residents to work at the interface of mental health and primary care. Acad Psychiatry. 2014. doi:10.1007/s40596-014-0081-3.
Norfleet K, Ratzliff A, Chan Y-F, Raney L, Unützer J. The role of the integrated care psychiatrist in community settings: a survey of psychiatrists’ perspectives. 2015. In press.
Heinrich TW, Schwartz AC, Zimbrean PC, Lolak S, Wright MT, Brooks KB, et al. Recommendations for training psychiatry residents in psychosomatic medicine. Psychosomatics. 2014. doi:10.1016/j.psym.2013.12.016.
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;62:629–40.
De Groot J. Psychiatric residency: an analysis of training activities with recommendations. Acad Psychiatry. 2000. doi:10.1176/appi.ap.24.3.139.
Onate J, Hales R, McCarron R, Han J, Pitman D. A novel approach to medicine training for psychiatry residents. Acad Psychiatry. 2008. doi:10.1176/appi.ap.32.6.518.
Dobscha SK, Snyder KM, Corson K, Ganzini L. Psychiatry resident graduate comfort with general medical issues: impact of an integrated psychiatry-primary medical care training track. Acad Psychiatry. 2005;29:448–51.
Cerimele JM, Popeo DM, Rieder RO. A resident rotation in collaborative care: learning to deliver primary care-based psychiatric services. Acad Psychiatry. 2013. doi:10.1176/appi.ap.12040075.
Yudkowsky R. So you want to train psychiatry residents in ambulatory primary care settings. Acad Psychiatry. 2000;24:133–8.
Kates N. Sharing mental health care. Training psychiatry residents to work with primary care physicians. Psychosomatics. 2000. doi:10.1016/S0033-3182(00)71173-X.
Dobscha SK, Ganzini L. A program for teaching psychiatric residents to provide integrated psychiatric and primary medical care. Psychiatr Serv. 2001;52:1651–3.
Thompson TL, Thomas MR. Teaching psychiatry to primary care internists. Gen Hosp Psychiatry. 1985;7:210–3.
Hodges B, Inch C, Silver I. Improving the psychiatric knowledge, skills, and attitudes of primary care physicians, 1950-2000: a review. Am J Psychiatry. 2001;158:1579–86.
Shaw D, Blue A. Should psychiatry champion interprofessional education? Acad Psychiatry. 2012. doi:10.1176/appi.ap.12020035.
Spiegel W, Tönies H, Scherer M, Katschnig H. Learning by doing: a novel approach to improving general practitioners’ diagnostic skills for common mental disorders. Wien Klin Wochenschr. 2007;119:117–23.
Benthem GH, Heg RR, van Leeuwen YD, Metsemakers JF. Teaching psychiatric diagnostics to general practitioners: educational methods and their perceived efficacy. Med Teach. 2009;31:e279–86.
Callen KE, Roberts JM. Psychiatric residents’ attitudes toward teaching. Am J Psychiatry. 1980;137:1104–6.
Lehmann SW. A longitudinal “teaching-to-teach” curriculum for psychiatric residents. Acad Psychiatry. 2010. doi:10.1176/appi.ap.34.4.282.
The Accreditation Council for Graduate Medical Education, The American Board of Psychiatry and Neurology. The psychiatry milestone project. 2013. http://acgme.org/acgmeweb/Portals/0/PDFs/Milestones/PsychiatryMilestones.pdf. Accessed 18 Sept 2014.
McLaren K, Lord J, Murray SB, Levy M, Ciechanowski P, Markman J, et al. Ownership of patient care: a behavioural definition and stepwise approach to diagnosing problems in trainees. Perspect Med Educ. 2013;2:72–86.
Mitchell P, Wynia M, Golden R, McNellis B, Okun S, Webb CE, Rohrbach V, Von Kohorn I. Core principles & values of effective team-based health care. Institute of Medicine of the National Academies. 2012. https://www.nationalahec.org/pdfs/VSRT-Team-Based-Care-Principles-values.pdf. Accessed 18 Sept 2014.
Curran V, Heath O, Adey T, Callahan T, Craig D, Hearn T, et al. An approach to integrating interprofessional education in collaborative mental health care. Acad Psychiatry. 2012. doi:10.1176/appi.ap.10030045.
Garfunkel LC, Pisani AR, leRoux P, Siegel DM. Educating residents in behavioral health care and collaboration: comparison of conventional and integrated training models. Acad Med. 2011. doi:10.1097/ACM.0b013e318204ff1d.
Cowley DS, Katon W, Veith RC. Training psychiatry residents as consultants in primary care settings. Acad Psychiatry. 2000;24:124–32.
Acknowledgments
The authors would like to acknowledge the technical support from Tess Grover and Melissa Farnum.
Disclosures
Dr. Anna Ratzliff, Dr. Jurgen Unutzer, and Dr. Ya-Fen Chan receive support in the form of contract for implementation support for the Community Health Plan of Washington. Dr. Kathryn Norfleet has no competing interests. Dr. Lori Raney is the owner of Collaborative Care Consulting.
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Ratzliff, A., Norfleet, K., Chan, YF. et al. Perceived Educational Needs of the Integrated Care Psychiatric Consultant. Acad Psychiatry 39, 448–456 (2015). https://doi.org/10.1007/s40596-015-0360-7
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DOI: https://doi.org/10.1007/s40596-015-0360-7