Skip to main content
Top
Published in: Community Mental Health Journal 4/2016

01-05-2016 | Original Paper

Recommendations for Primary Care Provided by Psychiatrists

Authors: Wesley Sowers, Melissa Arbuckle, Sosunmolu Shoyinka

Published in: Community Mental Health Journal | Issue 4/2016

Login to get access

Abstract

Recent studies have shown that people with severe mental illness have a dramatically lower life expectancy than the general population. Psychiatrists have not traditionally been very attentive to or involved with physical health issues and there has been growing emphasis on integrated care for physical and mental health and access to primary care for all members of the population. This paper examines the role of psychiatrists in the provision of primary care to the patients they treat. Some recommendations are offered for their involvement in the provision of primary care at three levels of complexity: Level 1—Universal Basic Psychiatric Primary Care; Level 2—Enhanced Psychiatric Primary Care; and Level 3—Fully Integrated Primary Care and Psychiatric Management. Some of the obstacles to the provision of primary care by psychiatrists are considered along with some suggestions for overcoming them.
Literature
go back to reference Alakeson, V., Frank, R. G., & Katz, R. E. (2010). Specialty care medical homes for people with severe, persistent mental disorders. Health Affairs (Project Hope), 20, 867–873.CrossRef Alakeson, V., Frank, R. G., & Katz, R. E. (2010). Specialty care medical homes for people with severe, persistent mental disorders. Health Affairs (Project Hope), 20, 867–873.CrossRef
go back to reference Bland, D. A., Lambert, K., & Raney, L. (2014). Resource document on risk management and liability issues in integrated care models. The American Journal of Psychiatry, 171(5), 1–7.CrossRefPubMed Bland, D. A., Lambert, K., & Raney, L. (2014). Resource document on risk management and liability issues in integrated care models. The American Journal of Psychiatry, 171(5), 1–7.CrossRefPubMed
go back to reference Butler, M., Kane, R. L., McAlpine, D., Kathol, R. G., Fu, S. S., Hagedorn, H., & Wilt, T. J. (2008). Integration of mental health/substance abuse and primary care no. 173 (Prepared by the Minnesota Evidence-based Practice Center under Contract No. 290-02-0009.) AHRQ publication no. 09E003. Rockville, MD.: Agency for Healthcare Research and Quality. Butler, M., Kane, R. L., McAlpine, D., Kathol, R. G., Fu, S. S., Hagedorn, H., & Wilt, T. J. (2008). Integration of mental health/substance abuse and primary care no. 173 (Prepared by the Minnesota Evidence-based Practice Center under Contract No. 290-02-0009.) AHRQ publication no. 09E003. Rockville, MD.: Agency for Healthcare Research and Quality.
go back to reference Cerimele, J. M., & Strain, J. J. (2010). Integrating primary care services into psychiatric care settings: A review of the literature. Primary Care Companion to the Journal of Clinical Psychiatry, 12(6), e1–e4. Cerimele, J. M., & Strain, J. J. (2010). Integrating primary care services into psychiatric care settings: A review of the literature. Primary Care Companion to the Journal of Clinical Psychiatry, 12(6), e1–e4.
go back to reference Croft, B., & Parish, S. L. (2013). Care integration in the Patient Protection and Affordable Care Act: Implications for behavioral health. Administration and Policy in Mental Health and Mental Health Services Research, 40(4), 258–263.CrossRefPubMed Croft, B., & Parish, S. L. (2013). Care integration in the Patient Protection and Affordable Care Act: Implications for behavioral health. Administration and Policy in Mental Health and Mental Health Services Research, 40(4), 258–263.CrossRefPubMed
go back to reference Deegan, P. (2010). A web application to support recovery and shared decision making in psychiatric medication clinics. Psychiatric Rehabilitation Journal, 34(1), 23–28.CrossRefPubMed Deegan, P. (2010). A web application to support recovery and shared decision making in psychiatric medication clinics. Psychiatric Rehabilitation Journal, 34(1), 23–28.CrossRefPubMed
go back to reference Dougherty, W. J., McDaniel, S. H., & Baird, M. A. (1996). Five levels of primary care/behavioral healthcare collaboration. Behavioral Healthcare Tomorrow, 5(5), 25–28. Dougherty, W. J., McDaniel, S. H., & Baird, M. A. (1996). Five levels of primary care/behavioral healthcare collaboration. Behavioral Healthcare Tomorrow, 5(5), 25–28.
go back to reference Druss, B. G., Esenwein, S. A., Compton, M. T., Zhao, L., & Leslie, D. L. (2011). Budget impact and sustainability of medical care management for persons with serious mental illnesses. American Journal of Psychiatry, 168, 1171–1178.CrossRefPubMedPubMedCentral Druss, B. G., Esenwein, S. A., Compton, M. T., Zhao, L., & Leslie, D. L. (2011). Budget impact and sustainability of medical care management for persons with serious mental illnesses. American Journal of Psychiatry, 168, 1171–1178.CrossRefPubMedPubMedCentral
go back to reference Druss, B. G., & Mauer, B. J. (2010). Health care reform and care at the behavioral health–primary care interface. Psychiatric Services, 61, 1087–1092.CrossRefPubMed Druss, B. G., & Mauer, B. J. (2010). Health care reform and care at the behavioral health–primary care interface. Psychiatric Services, 61, 1087–1092.CrossRefPubMed
go back to reference Druss, B. G., Rohrbaugh, R. M., Levinson, C. M., & Rosenheck, R. A. (2001). Integrated medical care for patients with serious psychiatric illness: A randomized trial. Archives of General Psychiatry, 58(9), 861–868.CrossRefPubMed Druss, B. G., Rohrbaugh, R. M., Levinson, C. M., & Rosenheck, R. A. (2001). Integrated medical care for patients with serious psychiatric illness: A randomized trial. Archives of General Psychiatry, 58(9), 861–868.CrossRefPubMed
go back to reference Golomb, B., Pyne, J., Wright, B., Jaworski, B., Lohr, J. B., & Bozzette, S. (2000). The role of psychiatrists in primary care of patients with severe mental illness. Psychiatric Services, 51(6), 766–773.CrossRefPubMed Golomb, B., Pyne, J., Wright, B., Jaworski, B., Lohr, J. B., & Bozzette, S. (2000). The role of psychiatrists in primary care of patients with severe mental illness. Psychiatric Services, 51(6), 766–773.CrossRefPubMed
go back to reference Hert, M., Cohen, D., Bobes, J., Cetkovich-Bakmas, M., Leucht, S., Ndetei, D., & Correll, C. (2011). Physical illness in patients with severe mental disorders. II. Barriers to care, monitoring and treatment guidelines, plus recommendations at the system and individual level. World Psychiatry, 10(2), 138–151.CrossRefPubMed Hert, M., Cohen, D., Bobes, J., Cetkovich-Bakmas, M., Leucht, S., Ndetei, D., & Correll, C. (2011). Physical illness in patients with severe mental disorders. II. Barriers to care, monitoring and treatment guidelines, plus recommendations at the system and individual level. World Psychiatry, 10(2), 138–151.CrossRefPubMed
go back to reference Hunter, C. L., & Goodie, J. L. (2010). Operational and clinical components for integrated-collaborative behavioral healthcare in the patient-centered medical home. Families, Systems, & Health, 28(4), 308–321.CrossRef Hunter, C. L., & Goodie, J. L. (2010). Operational and clinical components for integrated-collaborative behavioral healthcare in the patient-centered medical home. Families, Systems, & Health, 28(4), 308–321.CrossRef
go back to reference Kates, N., Craven, M., Crustolo, A. M., Nikolaou, L., & Allen, C. (1987). Integrating mental health services within primary care: A Canadian program. General Hospital Psychiatry, 19(5), 324–332.CrossRef Kates, N., Craven, M., Crustolo, A. M., Nikolaou, L., & Allen, C. (1987). Integrating mental health services within primary care: A Canadian program. General Hospital Psychiatry, 19(5), 324–332.CrossRef
go back to reference Katon, W. J., Lin, E. H., Von Korff, M., Ciechanowski, P., Ludman, E. J., Young, B., & McCulloch, D. (2010). Collaborative care for patients with depression and chronic illnesses. New England Journal of Medicine, 363(27), 2611–2620.CrossRefPubMedPubMedCentral Katon, W. J., Lin, E. H., Von Korff, M., Ciechanowski, P., Ludman, E. J., Young, B., & McCulloch, D. (2010). Collaborative care for patients with depression and chronic illnesses. New England Journal of Medicine, 363(27), 2611–2620.CrossRefPubMedPubMedCentral
go back to reference Katon, W., & Unutzer, J. (2011). Conulstation psychiatry in the medical home and accountable care organizations: Achieving the triple aim. General Hospital Psychiatry, 33(4), 305–310.CrossRefPubMedPubMedCentral Katon, W., & Unutzer, J. (2011). Conulstation psychiatry in the medical home and accountable care organizations: Achieving the triple aim. General Hospital Psychiatry, 33(4), 305–310.CrossRefPubMedPubMedCentral
go back to reference Kisely, S., Duerden, D., Shaddick, S., & Jayabarathan, A. (2006). Collaboration between primary care and psychiatric services: Does it help family physicians? Canadian Family Physician, 52(7), 876–877.PubMed Kisely, S., Duerden, D., Shaddick, S., & Jayabarathan, A. (2006). Collaboration between primary care and psychiatric services: Does it help family physicians? Canadian Family Physician, 52(7), 876–877.PubMed
go back to reference Marder, S. R., Essock, S. M., Miller, A. L., et al. (2004). Physical health monitoring of patients with schizophrenia. American Journal of Psychiatry, 161, 1334–1349.CrossRefPubMed Marder, S. R., Essock, S. M., Miller, A. L., et al. (2004). Physical health monitoring of patients with schizophrenia. American Journal of Psychiatry, 161, 1334–1349.CrossRefPubMed
go back to reference Mechanic, D. (2012). Seizing opportunities under the Affordable Care Act for transforming the mental and behavioral health system. Health Affairs, 31(2), 376–382.CrossRefPubMed Mechanic, D. (2012). Seizing opportunities under the Affordable Care Act for transforming the mental and behavioral health system. Health Affairs, 31(2), 376–382.CrossRefPubMed
go back to reference Mercer, S. W., Gunn, J., Bower, P., Wyke, S., & Guthrie, B. (2012). Managing patients with mental and physical multimorbidity. BMJ, 345, e5559.CrossRefPubMed Mercer, S. W., Gunn, J., Bower, P., Wyke, S., & Guthrie, B. (2012). Managing patients with mental and physical multimorbidity. BMJ, 345, e5559.CrossRefPubMed
go back to reference Miller, C. L., Druss, B. G., Dombrowski, E. A., & Rosenheck, R. A. (2003). Barriers to primary medical care among patients at a community mental health center. Psychiatric Services., 54(8), 1158–1160.CrossRef Miller, C. L., Druss, B. G., Dombrowski, E. A., & Rosenheck, R. A. (2003). Barriers to primary medical care among patients at a community mental health center. Psychiatric Services., 54(8), 1158–1160.CrossRef
go back to reference NYS Center of Excellence for Cultural Competence. (2010) Improving the physical health of people with serious mental illness: A systematic review of lifestyle interventions: A Report from the NYS Center of Excellence for Cultural Competence at the New York State Psychiatric Institute. New York, NY. NYS Center of Excellence for Cultural Competence. (2010) Improving the physical health of people with serious mental illness: A systematic review of lifestyle interventions: A Report from the NYS Center of Excellence for Cultural Competence at the New York State Psychiatric Institute. New York, NY.
go back to reference Parks, J. (2007). Implementing practice guidelines: Lessons from public mental health settings. Journal of Clinical Psychiatry, 68(suppl 4), 45–48.PubMed Parks, J. (2007). Implementing practice guidelines: Lessons from public mental health settings. Journal of Clinical Psychiatry, 68(suppl 4), 45–48.PubMed
go back to reference Pincus, H. A. (1987). Patient-oriented models for linking primary care and mental health care. General Hospital Psychiatry, 9(2), 95–101.CrossRefPubMed Pincus, H. A. (1987). Patient-oriented models for linking primary care and mental health care. General Hospital Psychiatry, 9(2), 95–101.CrossRefPubMed
go back to reference Pollack, D. A., Raney, L. E., & Vanderlip, E. R. (2012). Integrated care and psychiatrists. In H. McQuistion, W. Sowers, J. Ranz & J. Feldman (Eds.), Handbook of Community Psychiatry. New York: Springer Publication. Pollack, D. A., Raney, L. E., & Vanderlip, E. R. (2012). Integrated care and psychiatrists. In H. McQuistion, W. Sowers, J. Ranz & J. Feldman (Eds.), Handbook of Community Psychiatry. New York: Springer Publication.
go back to reference Pomerantz, A. S., & Sayers, S. L. (2010). Primary care-mental health integration in healthcare in the Department of Veterans Affairs. Families, Systems, & Health, 28(2), 78–82.CrossRef Pomerantz, A. S., & Sayers, S. L. (2010). Primary care-mental health integration in healthcare in the Department of Veterans Affairs. Families, Systems, & Health, 28(2), 78–82.CrossRef
go back to reference Sani, K. M. (2006). Monitoring the physical health of psychiatric patients on psychotropic drugs. Psychiatric Bulletin, 30, 468–469.CrossRef Sani, K. M. (2006). Monitoring the physical health of psychiatric patients on psychotropic drugs. Psychiatric Bulletin, 30, 468–469.CrossRef
go back to reference Shore, J. H. (1996). Psychiatry at a crossroad: Our role in primary care. American Jornal of Psychiatry, 153(11), 1398–1403.CrossRef Shore, J. H. (1996). Psychiatry at a crossroad: Our role in primary care. American Jornal of Psychiatry, 153(11), 1398–1403.CrossRef
go back to reference Strathdee, G. (1987). Primary care—Psychiatry interaction: A British perspective. General Hospital Psychiatry, 9(2), 102–110.CrossRefPubMed Strathdee, G. (1987). Primary care—Psychiatry interaction: A British perspective. General Hospital Psychiatry, 9(2), 102–110.CrossRefPubMed
go back to reference Tanielian, T., Pincus, H. A., Dietrich, A. J., et al. (2000). Referrals to Psychiatrists: Assessing the communication interface between psychiatry and primary care. Psychosomatics, 41(3), 245–252.CrossRefPubMed Tanielian, T., Pincus, H. A., Dietrich, A. J., et al. (2000). Referrals to Psychiatrists: Assessing the communication interface between psychiatry and primary care. Psychosomatics, 41(3), 245–252.CrossRefPubMed
go back to reference Unützer, J., Chan, Y. F., Hafer, E., Knaster, J., Shields, A., Powers, D., & Veith, R. C. (2012). Quality improvement with pay-for-performance incentives in integrated behavioral health care. American Journal of Public Health, 102(6), e41–e45.CrossRefPubMedPubMedCentral Unützer, J., Chan, Y. F., Hafer, E., Knaster, J., Shields, A., Powers, D., & Veith, R. C. (2012). Quality improvement with pay-for-performance incentives in integrated behavioral health care. American Journal of Public Health, 102(6), e41–e45.CrossRefPubMedPubMedCentral
go back to reference Vreeland, B. (2007). Bridging the gap between mental and physical health: A multidisciplinary approach. Journal of Clinical Psychiatry, 68(suppl 4), 26–33.PubMed Vreeland, B. (2007). Bridging the gap between mental and physical health: A multidisciplinary approach. Journal of Clinical Psychiatry, 68(suppl 4), 26–33.PubMed
go back to reference Woltmann, E., Grogan-Kaylor, A., Perron, B., Georges, H., Kilbourne, A. M., & Bauer, M. (2012). Comparative effectiveness of collaborative chronic care models for mental health conditions across primary, specialty, and behavioral health care settings: Systematic review and meta-analysis. American Journal of Psychiatry, 169(8), 790–804.CrossRefPubMed Woltmann, E., Grogan-Kaylor, A., Perron, B., Georges, H., Kilbourne, A. M., & Bauer, M. (2012). Comparative effectiveness of collaborative chronic care models for mental health conditions across primary, specialty, and behavioral health care settings: Systematic review and meta-analysis. American Journal of Psychiatry, 169(8), 790–804.CrossRefPubMed
go back to reference Zivin, K., Pfeiffer, P. N., Szymanski, B. R., Valenstein, M., Post, E. P., Miller, E. M., & McCarthy, J. F. (2010). Initiation of primary care—Mental health integration programs in the VA health system: Associations with psychiatric diagnoses in primary care. Medical Care, 48(9), 843–851.CrossRefPubMed Zivin, K., Pfeiffer, P. N., Szymanski, B. R., Valenstein, M., Post, E. P., Miller, E. M., & McCarthy, J. F. (2010). Initiation of primary care—Mental health integration programs in the VA health system: Associations with psychiatric diagnoses in primary care. Medical Care, 48(9), 843–851.CrossRefPubMed
Metadata
Title
Recommendations for Primary Care Provided by Psychiatrists
Authors
Wesley Sowers
Melissa Arbuckle
Sosunmolu Shoyinka
Publication date
01-05-2016
Publisher
Springer US
Published in
Community Mental Health Journal / Issue 4/2016
Print ISSN: 0010-3853
Electronic ISSN: 1573-2789
DOI
https://doi.org/10.1007/s10597-015-9983-0

Other articles of this Issue 4/2016

Community Mental Health Journal 4/2016 Go to the issue