Providing Mental Health Services in the Primary Care Setting: the Experiences and Perceptions of General Practitioners at a New York City Clinic
Abstract
Mental illness is a significant cause of disability worldwide, including here in the United States. Given the shortage of trained mental health professionals, a significant portion of patients needing care are managed in the primary care setting. Accountable Care Organizations (ACOs), for example, are seeking to improve the quality of care for this vulnerable population, but many are facing significant challenges relating to integration of new services. We sought to elucidate barriers faced by primary care practitioners (PCPs)-physicians, physician trainees and nurse practitioners-at a New York primary care clinic, which impede delivery of optimal care to those suffering from mental illness. The study was conducted with 32 PCPs in 2016-2017 at Mount Sinai Internal Medicine Associates in New York City. For the quantitative component of the study, a 54-item questionnaire was devised to assess their attitude, behavior and confidence in managing psychiatric patients. For the qualitative component, data was obtained from 3 open-ended questions. Responses were coded for salient themes. Analysis revealed a range of difficulties faced by PCPs. Overall, participants felt that the need to integrate mental health care into primary care was important, however they reported significant barriers in terms of lack of time, lack of resources, low confidence in treating more complex mental health conditions and difficulties with referring patient to mental health specialists. Despite a growing body of evidence that integration of mental health services in primary care leads to improved outcomes, addressing barriers to care will be key to ensuring feasibility of integration measures.
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GPs report a lack of tools needed to administer psychological care, including lack of time, resources, and confidence.
“GPs report the lack of tools needed to administer psychological care, including a lack of time, resources, and confidence [5].”
From Web-Based Interventions to Help Australian Adults Address Depression, Anxiety, Suicidal Ideation, and General Mental Well-being: Scoping Review (2022) · cites this paper as [5]
Cites
Vos, T., Abajobir, A. A., Abate, K. H., Abbafati, C., Abbas, K. M., Abd-Allah, F., Abdulkader, R. S., Abdulle, A. M., Abebo, T. A., Abera, S. F., et al. (2017) · The Lancet · doi:10.1016/s0140-6736(17)32154-2 · Cited by 13,220 · see citing works
Unützer, J., Katon, W., Callahan, C. M., Williams, Jr., Hunkeler, E., Harpole, L., Hoffing, M., Della Penna, R. D., Noël, P. H., Lin, E. H. B., et al. (2002) · JAMA · doi:10.1001/jama.288.22.2836 · Cited by 2,405 · see citing works
Evidence-based health policy—lessons from the Global Burden of Disease Study
Murray, C. J. L., & Lopez, A. D. (1996) · Science · doi:10.1126/science.274.5288.740 · Cited by 2,178 · see citing works
Collaborative care for patients with depression and chronic illnesses
Katon, W. J., Lin, E. H. B., Von Korff, M., Ciechanowski, P., Ludman, E. J., Young, B., Peterson, D., Rutter, C. M., McGregor, M., & McCulloch, D. (2010) · New England Journal of Medicine · doi:10.1056/nejmoa1003955 · Cited by 1,697 · see citing works
Collaborative care for depression and anxiety problems
Archer, J., Bower, P., Gilbody, S., Lovell, K., Richards, D., Gask, L., Dickens, C., & Coventry, P. (2012) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd006525.pub2 · Cited by 1,126 · see citing works
Scott, D. S., & Happell, B. (2011) · Issues in Mental Health Nursing · doi:10.3109/01612840.2011.569846 · Cited by 419 · see citing works
Medical Morbidity, Mental Illness, and Substance Use Disorders
Dickey, B., Normand, S. T., Weiss, R. D., Drake, R. E., & Azeni, H. (2002) · Psychiatric Services · doi:10.1176/appi.ps.53.7.861 · Cited by 400 · see citing works
High prevalence of mental disorders in primary care
Ansseau, M., Dierick, M., Buntinkx, F., Cnockaert, P., De Smedt, J., Van Den Haute, M., & Vander Mijnsbrugge, D. (2004) · Journal of Affective Disorders · doi:10.1016/s0165-0327(02)00219-7 · Cited by 352 · see citing works
Integrated Primary Care: Organizing the Evidence.
Blount, A. (2003) · Families Systems & Health · doi:10.1037/1091-7527.21.2.121 · Cited by 316 · see citing works
Cost-effectiveness of a Multicondition Collaborative Care Intervention
Russo, J. (2012) · Archives of General Psychiatry · doi:10.1001/archgenpsychiatry.2011.1548 · Cited by 287 · see citing works
Collaborative Care for Adolescents With Depression in Primary Care: A Randomized Clinical Trial
Richardson, L. P., Ludman, E., McCauley, E., Lindenbaum, J., Larison, C., Zhou, C., Clarke, G., Brent, D., & Katon, W. (2014) · JAMA · doi:10.1001/jama.2014.9259 · Cited by 281 · see citing works
Katon, W. J., Unützer, J., Fan, M.-Y., Williams, J. W., Schoenbaum, M., Lin, E. H. B., & Hunkeler, E. M. (2006) · Diabetes Care · doi:10.2337/diacare.29.02.06.dc05-1572 · Cited by 259 · see citing works
Predictors and Outcomes of Burnout in Primary Care Physicians
Rabatin, J. S., Williams, E. S., Manwell, L. B., Schwartz, M. D., Brown, R., & Linzer, M. (2015) · Journal of Primary Care & Community Health · doi:10.1177/2150131915607799 · Cited by 215 · see citing works
Crowley, R. A., & Kirschner, N. M. (2015) · Annals of Internal Medicine · doi:10.7326/m15-0510 · Cited by 211 · see citing works
Lin, E. H. B., Von Korff, M., Ciechanowski, P., Peterson, D., Ludman, E. J., Rutter, C. M., Oliver, M., Young, B. A., Gensichen, J., McGregor, M., et al. (2012) · The Annals of Family Medicine · doi:10.1370/afm.1343 · Cited by 150 · see citing works
Morbilidad psiquiátrica en pacientes mayores de 18 años
King, M. (n.d.) · DOAJ (DOAJ: Directory of Open Access Journals) · Cited by 112 · see citing works
Bridging the gap between mental and physical health: a multidisciplinary approach.
Vreeland, B. (2007) · PubMed · Cited by 111 · see citing works
Davis, M. M., Balasubramanian, B. A., Waller, E., Miller, B. F., Green, L. A., & Cohen, D. J. (2013) · The Journal of the American Board of Family Medicine · doi:10.3122/jabfm.2013.05.130028 · Cited by 97 · see citing works
Raney, L. E., Bergman, D., Torous, J. B., & Hasselberg, M. J. (2017) · Current Psychiatry Reports · doi:10.1007/s11920-017-0838-y · Cited by 76 · see citing works
Chronic Physical Conditions in Older Adults with Mental Illness and/ or Substance Use Disorders
Lin, W., Zhang, J., Leung, G. Y., & Clark, R. E. (2011) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.2011.03588.x · Cited by 66 · see citing works
Chwastiak, L., Jackson, S. L., Russo, J. E., DeKeyser, P., Kiefer, M. M., Belyeu, B. M., Mertens, K., Chew, L. D., & Lin, E. H. B. (2016) · General Hospital Psychiatry · doi:10.1016/j.genhosppsych.2016.10.005 · Cited by 61 · see citing works
Knowledge of and Attitudes Toward Clinical Depression Among Health Providers in Gujarat, India
Almanzar, S., Shah, N., Vithalani, S., Shah, S. H., Squires, J., Appasani, R. K., & Katz, C. L. (2014) · Annals of Global Health · doi:10.1016/j.aogh.2014.04.001 · Cited by 52 · see citing works
Self-citationKeeley, R. D., West, D. R., Tutt, B., & Nutting, P. A. (2014) · BMC Family Practice · doi:10.1186/1471-2296-15-13 · Cited by 33 · see citing works
Loh, D. A., Joshi, A., Taku, K., Mendelsohn, N., & Katz, C. L. (2017) · Psychiatric Quarterly · doi:10.1007/s11126-017-9530-y · Cited by 10 · see citing works
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Skaczkowski, G., van der Kruk, S., Loxton, S., Hughes-Barton, D., Howell, C., Turnbull, D., Jensen, N., Smout, M., & Gunn, K. (2022) · JMIR Mental Health · doi:10.2196/31018 · Cited by 9 · see citing works
“However, GPs report the lack of tools needed to administer psychological care, including a lack of time, resources, and confidence [5].”
Background
- Authors
- Bagayogo, I. P., Turcios-Wiswe, K., Taku, K., Peccoralo, L., & Katz, C. L.
- Affiliations
- Mount Sinai Beth Israel (US)
- Icahn School of Medicine at Mount Sinai (US)
- Oakland University (US)
- Corresponding author
- Bagayogo, Issa Papiss
- Venue
- Psychiatric Quarterly
- Published
- 2018-07-02
- Volume
- 89
- Issue
- 4
- Pages
- 897-908
- ISSN
- 0033-2720 (ISSN-L)
- 1573-6709
- OpenAlex
- W2809853030
- Cited by
- 26
- References
- 24
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 2 · 2023: 4 · 2022: 5 · 2021: 3 · 2020: 6 · 2019: 1 · 2018: 1
- FWCI
- 3.72
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Psychiatric Quarterly (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Health Sciences › Health Professions › General Health Professions › Primary Care and Health Outcomes
- Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
- Keywords
- mental health integration, primary care, general practitioners, barriers to care, physician attitudes, physician confidence, nurse practitioners, physician trainees, mental illness, accountable care organizations, New York City
- MeSH terms
- Adult, Aged, Attitude of Health Personnel, Female, Humans, Health Knowledge, Attitudes, Practice, Male, Mental Health Services, Middle Aged, New York City, Primary Health Care, Delivery of Health Care, Integrated, Young Adult, General Practitioners
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