The DOI matches its Crossref record; 61 of the 61 references it cites were found in a registry or an index.
Closing the False Divide: Sustainable Approaches to Integrating Mental Health Services into Primary Care
Open accessAbstract
Mental disorders account for 25% of all health-related disability worldwide. More patients receive treatment for mental disorders in the primary care sector than in the mental health specialty setting. However, brief visits, inadequate reimbursement, deficits in primary care provider (PCP) training, and competing demands often limit the capacity of the PCP to produce optimal outcomes in patients with common mental disorders. More than 80 randomized trials have shown the benefits of collaborative care (CC) models for improving outcomes of patients with depression and anxiety. Six key components of CC include a population-based approach, measurement-based care, treatment to target strategy, care management, supervision by a mental health professional (MHP), and brief psychological therapies. Multiple trials have also shown that CC for depression is equally or more cost-effective than many of the current treatments for medical disorders. Factors that may facilitate the implementation of CC include a more favorable alignment of medical and mental health services in accountable care organizations and patient-centered medical homes; greater use of telecare as well as automated outcome monitoring; identification of patients who might benefit most from CC; and systematic training of both PCPs and MHPs in integrated team-based care.
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“Primary care and specialist medical providers are busy, do not have straightforward access to behavioural treatment for their patients and patients are often not compliant even if referred for behavioural health services.5”
From A study protocol for a non-randomised comparison trial evaluating the feasibility and effectiveness of a mobile cognitive-behavioural programme with integrated coaching for anxious adults in primary care (2018) · cites this paper as [5]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Primary care and specialist medical providers are busy, do not have straightforward access to behavioural treatment for their patients and patients are often not compliant even if referred for behavioural health services.5”
From A study protocol for a non-randomised comparison trial evaluating the feasibility and effectiveness of a mobile cognitive-behavioural programme with integrated coaching for anxious adults in primary care (2018) · cites this paper as [5]
Experimental — accuracy not yet measuredIn the citing paper
“Integrating mental health services into primary care and shifting the provision of evidence-based psychosocial treatments to non-specialist health workers such as community health workers, lay persons, and other frontline health workers has emerged as a highly promising approach.5,6”
From Digital Technology for Building Capacity of Nonspecialist Health Workers for Task Sharing and Scaling Up Mental Health Care Globally (2019) · cites this paper as [6]
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Cites
Vos, T., Flaxman, A. D., Naghavi, M., Lozano, R., Michaud, C., Ezzati, M., Shibuya, K., Salomon, J. A., Abdalla, S., Aboyans, V., et al. (2012) · The Lancet · doi:10.1016/s0140-6736(12)61729-2 · Cited by 8,291
Wang, P. S., Lane, M., Olfson, M., Pincus, H. A., Wells, K. B., & Kessler, R. C. (2005) · Archives of General Psychiatry · doi:10.1001/archpsyc.62.6.629 · Cited by 2,695 · cited 1×
“Fewer than one in four adults with a diagnosable mental disorder receive care from a mental health professional in any given year.(6) Many patients prefer receiving treatment from providers with whom they already have an established health care relationship.”
BackgroundThe State of US Health, 1990-2010: Burden of Diseases, Injuries, and Risk Factors
Murray, C. J. L. (2013) · JAMA · doi:10.1001/jama.2013.13805 · Cited by 2,438 · cited 1×
“Depression and anxiety are each present in about 10% of primary care patients in the US(2) and are the first and fifth most common causes of years lived with disability (YLDs) among all diseases.(3) Indeed, depression and anxiety alone account for as many YLDs in the US as do chronic obstructive pulmonary disease, dia…”
BackgroundEffect Sizes for Interpreting Changes in Health Status
Kazis, L. E., Anderson, J. J., & Meenan, R. F. (1989) · Medical Care · doi:10.1097/00005650-198903001-00015 · Cited by 2,401
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
Katon, W. J. (2003) · Biological Psychiatry · doi:10.1016/s0006-3223(03)00273-7 · Cited by 1,248
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
Depression, anxiety and somatization in primary care: Syndrome overlap and functional impairment
Löwe, B., Spitzer, R. L., Williams, J. B. W., Mussell, M., Schellberg, D., & Kroenke, K. (2008) · General Hospital Psychiatry · doi:10.1016/j.genhosppsych.2008.01.001 · Cited by 706
Self-citationWoltmann, E., Grogan-Kaylor, A., Perron, B., Georges, H., Kilbourne, A. M., & Bauer, M. S. (2012) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2012.11111616 · Cited by 603
Collaborative Care to Improve the Management of Depressive Disorders
Thota, A. B., Sipe, T. A., Byard, G. J., Zometa, C. S., Hahn, R. A., McKnight-Eily, L. R., Chapman, D. P., Abraído‐Lanza, A. F., Pearson, J. L., Anderson, C. W., et al. (2012) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2012.01.019 · Cited by 492
Research works printed but not linked: 2
- Chung H, Rostanski N, Glassberg H, Pincus HA. Advancing integration of behavioral health into primary care: a continuum-based framework. New York: United Health Fund; 2016.
- Vanderlip ER, Rundell J, Avery M, et al. Dissemination of integrated care within adult primary care settings: the collaborative care model. Washington DC: American Psychiatric Association and Academy of Psychosomatic Medicine; 2016.
Cited by
Sorted by citations
Implementing Measurement-Based Care in Behavioral Health: A Review
Lewis, C. C., Boyd, M., Puspitasari, A., Navarro, E., Howard, J., Kassab, H., Hoffman, M., Scott, K., Lyon, A., Douglas, S., et al. (2019) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2018.3329 · Cited by 605
Self-citationPatel, J. S., Oh, Y., Rand, K. L., Wu, W., Cyders, M. A., Kroenke, K., & Stewart, J. C. (2019) · Depression and Anxiety · doi:10.1002/da.22940 · Cited by 306
Self-citationRaviola, G., Naslund, J. A., Smith, S. L., & Patel, V. (2019) · Current Psychiatry Reports · doi:10.1007/s11920-019-1028-x · Cited by 258
PHQ ‐9: global uptake of a depression scale
Kroenke, K. (2021) · World Psychiatry · doi:10.1002/wps.20821 · Cited by 209
Self-citationNaslund, J. A., Shidhaye, R., & Patel, V. (2019) · Harvard Review of Psychiatry · doi:10.1097/hrp.0000000000000217 · Cited by 159
Metadata
- Authors
- Kroenke, K., & Unutzer, J.
- Affiliations
- Regenstrief Institute (US)
- Corresponding author
- Kroenke, Kurt
- ORCID
- Kroenke, Kurt
- Venue
- Journal of General Internal Medicine
- Published
- 2017-02-27
- Volume
- 32
- Issue
- 4
- Pages
- 404-410
- ISSN
- 0884-8734 (ISSN-L)
- 1525-1497
- PMC
- PMC5377893
- OpenAlex
- W2591581327
- Cited by
- 231
- References
- 61
- Citations by year
- 2026: 17 · 2025: 13 · 2024: 19 · 2023: 31 · 2022: 32 · 2021: 53 · 2020: 23 · 2019: 16 · 2018: 15 · 2017: 12
- FWCI
- 25.83
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- Journal of General Internal Medicine (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- IUScholarWorks (Indiana University) (submittedVersion, cc-by)
- PMC
- Funders
- California Health Care Foundation
- Society of General Internal Medicine
- University of California, Davis
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
- Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
- Health Sciences › Medicine › Family Practice › Primary Care and Health Outcomes
- Keywords
- integrated mental health services, primary care, collaborative care, depression, anxiety, common mental disorders, measurement-based care, treat-to-target, care management, cost-effectiveness, accountable care organizations, patient-centered medical home, telecare, team-based care, implementation barriers
- MeSH terms
- Mental Disorders, Cost-Benefit Analysis, Humans, Mental Health Services, Primary Health Care, Models, Organizational, Delivery of Health Care, Integrated, Vulnerable Populations
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