Urgent need for improved mental health care and a more collaborative model of care

Lake, James; Turner, Mason Spain

doi:10.7812/tpp/17-024

Cited by 201Psychiatric care and mental health servicesMental Health Treatment and AccessInterprofessional Education and Collaboration

Urgent need for improved mental health care and a more collaborative model of care

Open access

Lake, James, Turner, Mason Spain·2017·The Permanente Journal

DOI 10.7812/tpp/17-024PMC PMC5593510

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Abstract

Current treatments and the dominant model of mental health care do not adequately address the complex challenges of mental illness, which accounts for roughly one-third of adult disability globally. These circumstances call for radical change in the paradigm and practices of mental health care, including improving standards of clinician training, developing new research methods, and re-envisioning current models of mental health care delivery. Because of its dominant position in the US health care marketplace and its commitment to research and innovation, Kaiser Permanente (KP) is strategically positioned to make important contributions that will shape the future of mental health care nationally and globally.This article reviews challenges facing mental health care and proposes an agenda for developing a collaborative care model in primary care settings that incorporates conventional biomedical therapies and complementary and alternative medicine approaches. By moving beyond treatment delivery via telephone and secure video and providing earlier interventions through primary care clinics, KP is shifting the paradigm of mental health care to a collaborative care model focusing on prevention. Recommendations are to expand current practices to include integrative treatment strategies incorporating evidence-based biomedical and complementary and alternative medicine modalities that can be provided to patients using a collaborative care model. Recommendations also are made for an internal research program aimed at investigating the efficacy and cost-effectiveness of promising complementary and alternative medicine and integrative treatments addressing the complex needs of patients with severe psychiatric disorders, many of whom respond poorly to treatments available in KP mental health clinics.

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Background
Effects of natural environment on mental health: an umbrella review of systematic reviews and meta-analysesPreprint
Hossain, M. M., Sultana, A., Ma, P., Fan, Q., Sharma, R., Purohit, N., & Sharmin, D. F. (2020) · doi:10.31234/osf.io/4r3mh · Cited by 27 · see citing works
Patients with psychiatric diagnoses have increased odds of morbidity and mortality in elective orthopedic surgery
Brown, A., Alas, H., Bortz, C. A., Pierce, K. E., Vasquez-Montes, D., Ihejirika-Lomedico, R. C., Segreto, F. A., Haskel, J. D., Kaplan, D. J., Segar, A. H., et al. (2020) · Journal of Clinical Neuroscience · doi:10.1016/j.jocn.2020.11.049 · Cited by 26 · see citing works
Fatality of 33‐Year‐Old Man Involving Kratom Toxicity
Matson, M., & Schenk, N. (2019) · Journal of Forensic Sciences · doi:10.1111/1556-4029.14082 · Cited by 24 · see citing works
“tional treatment modalities are being sought by patients for alleviation of symptoms (1).”
Background
Genetic feedback for psychiatric conditions: Where are we now and where are we going
Driver, M. N., Kuo, S. I., & Dick, D. M. (2020) · American Journal of Medical Genetics Part B Neuropsychiatric Genetics · doi:10.1002/ajmg.b.32815 · Cited by 23 · see citing works
Exploring Usability and Patient Attitude towards a Smart Hospital Service with the Technology Acceptance Model
Tu, J.-C., Luo, S.-C., Lee, Y.-L., Shih, M.-F., & Chiu, S.-P. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph19106059 · Cited by 23 · see citing works
“Some patients come to the hospital to seek psychological treatments, and they need to communicate with doctors to relieve their inner anxiety instead of receiving medical diagnoses and treatments [52].”
Background
Healthcare utilization of individuals with substance use disorders following Affordable Care Act implementation in a California healthcare system
Satre, D. D., Palzes, V. A., Young-Wolff, K. C., Parthasarathy, S., Weisner, C., Guydish, J., & Campbell, C. I. (2020) · Journal of Substance Abuse Treatment · doi:10.1016/j.jsat.2020.108097 · Cited by 22 · see citing works
A modeling-based approach to optimize COVID-19 vaccine dosing schedules for improved protection
Dogra, P., Schiavone, C., Wang, Z., Ruiz-Ramírez, J., Caserta, S., Staquicini, D. I., Markosian, C., Wang, J., Sostman, D. H., Pasqualini, R., et al. (2023) · JCI Insight · doi:10.1172/jci.insight.169860 · Cited by 20 · see citing works
Using Meditation to Reduce Stress, Anxiety, and Depression in Nursing Students
Holden, S., & O’Connell, K. A. (2023) · Journal of Nursing Education · doi:10.3928/01484834-20230612-02 · Cited by 21 · see citing works
Nonlinear classification of emotion from EEG signal based on maximized mutual information
Ghosh, S. M., Bandyopadhyay, S., & Mitra, D. (2021) · Expert Systems with Applications · doi:10.1016/j.eswa.2021.115605 · Cited by 18 · see citing works
Self-help: a Systematic Review of the Efficacy of Mental Health Apps for Low- and Middle-Income Communities
Gama, B., & Laher, S. (2023) · Journal of Technology in Behavioral Science · doi:10.1007/s41347-023-00360-z · Cited by 18 · see citing works
“However, increasing mental healthcare needs cannot be solely taken up by community healthcare and require a supporting practice that further improves the training for clinicians and re-envisions the delivery of mental health care (Lake & Turner, 2017).”
A qualitative exploration of mental health services provided in community pharmacies
Crespo-González, C., Dineen‐Griffin, S., Rae, J., & Hill, R. A. (2022) · PLoS ONE · doi:10.1371/journal.pone.0268259 · Cited by 18 · see citing works
Automatic Detection of Mental Health Status using Alpha Subband of EEG Data
Ranjan, R., Neeti, & Sahana, B. C. (2022) · IEEE International Symposium on Medical Measurements and Applications (MeMeA) · doi:10.1109/memea54994.2022.9856586 · Cited by 19 · see citing works
“The treatment of mental illness requires long-term medications [7] which puts a heavy financial strain on the family.”
Background
Perceptions of mental health providers of the barriers and facilitators of using and engaging youth in digital mental-health-enabled measurement based care
Bassi, E. M., Bright, K. S., Norman, L., Pintson, K., Daniel, S., Sidhu, S., Gondziola, J., Bradley, J., Fersovitch, M., Stamp, L. K., et al. (2024) · Digital Health · doi:10.1177/20552076241253093 · Cited by 19 · see citing works
“3,4 Emerging evidence suggests that a substantial portion of mental health issues originate in childhood or adolescence, highlighting the importance of early intervention and support to facilitate positive long-term outcomes and mitigate the burden of mental illness in adulthood.”
Background
US Integrated Delivery Networks Perspective on Economic Burden of Patients with Treatment-Resistant Depression: A Retrospective Matched-Cohort Study
Pilon, D., Szukis, H., Joshi, K., Singer, D., Sheehan, J. J., Wu, J. W., Lefèbvre, P., & Greenberg, P. E. (2019) · PharmacoEconomics - Open · doi:10.1007/s41669-019-0154-z · Cited by 18 · see citing works
Neglecting Maternal Depression Compromises Child Health and Development Outcomes, and Violates Children’s Rights in South Africa
Mokwena, K. E. (2021) · Children · doi:10.3390/children8070609 · Cited by 20 · see citing works
“It is for this reason that an urgent need for improved mental health care has been identified [19].”
Background
A Review of Mixed Methods Community-Based Participatory Research Applications in Mental Health
Jones, D. E., Lindquist-Grantz, R., & DeJonckheere, M. J. (2020) · Journal of Social Behavioral and Health Sciences · doi:10.5590/jsbhs.2020.14.1.18 · Cited by 16 · see citing works
“Some of these include but are not limited to healthcare access, food security, housing stability, environmental health, and crime rates (Jones et al., 2017; Lake & Turner, 2017; Silva et al., 2016), as well as documented racial and ethnic disparities (American Psychiatric Association, 2017).”
Background
A Local Community-Based Social Network for Mental Health and Well-being (Quokka): Exploratory Feasibility Study
Shih, C. W., Pudipeddi, R., Uthayakumar, A., & Washington, P. Y. (2021) · JMIRx Med · doi:10.2196/24972 · Cited by 15 · see citing works
“Mental health conditions account for one-third of adult health conditions, and suicide is the leading cause of death among people 15-29 years of age [1].”
Background
Bioresonance, an alternative therapy for mild and moderate depression
Muresan, D., Voidăzan, S. T., Sălcudean, A., Bodo, C. R., & Grecu, I. G. (2022) · Experimental and Therapeutic Medicine · doi:10.3892/etm.2022.11190 · Cited by 16 · see citing works
“In the current model of mental illness care, widely used treat‐ ments include pharmacological medication, psychotherapeutic techniques such as psychotherapy, cognitive‐behavioral therapy and also electroconvulsive therapy and transcranial magnetic stimulation (18,19).”
Method
A Narrative Review on REM Sleep Deprivation: A Promising Non-Pharmaceutical Alternative for Treating Endogenous Depression
Crișan, C. A., Milhem, Z., Stretea, R., Țața, I.-M., Cherecheș, R. M., & Micluția, I. (2023) · Journal of Personalized Medicine · doi:10.3390/jpm13020306 · Cited by 17 · see citing works
“Taken together, the constantly growing incidence of endogenous depression, the inconveniences associated with the currently available therapeutic options, and the related economic burden, create a clear demand for the development of more convenient ways to spot and alleviate the symptoms of endogenous depression [67,6…”
Background
Incorporating a Stepped Care Approach Into Internet-Based Cognitive Behavioral Therapy for Depression: Randomized Controlled Trial
Jagayat, J., Kumar, A., Shao, Y., Pannu, A., Patel, C. B., Shirazi, A., Omrani, M., & Alavi, N. (2023) · JMIR Mental Health · doi:10.2196/51704 · Cited by 15 · see citing works
“Despite the negative consequences of depression, only one-third of individuals receive treatment, and of those, only 3 in 5 people receive sufficient care [7,8].”
Sedentary Habits and Their Detrimental Impact on Global Health: A Viewpoint
Singh, C., Bandre, G. R., Gajbe, U., Shrivastava, S. R., Tiwade, Y. R., Bankar, N. J., & Moizuddin, K. (2024) · National Journal of Community Medicine · doi:10.55489/njcm.150220243590 · Cited by 20 · see citing works
Stem cell-based models and therapies: a key approach into schizophrenia treatment
Larijani, B. A., Roudsari, P. P., Hadavandkhani, M., Alavi-Moghadam, S., Rezaei–Tavirani, M., Goodarzi, P., Sayahpour, F. A., Mohamadi-Jahani, F., & Arjmand, B. (2021) · Cell and Tissue Banking · doi:10.1007/s10561-020-09888-3 · Cited by 16 · see citing works
“Hereupon, also discovering more appropriate therapies for schizophrenia as one of the most serious of all psychiatric disorders, can be considered as an important social health issue (Lake and Turner 2017; Soliman et al. 2017).”
Background
Efficacy of Intellect’s self-guided anxiety and worry mobile health programme: A randomized controlled trial with an active control and a 2-week follow-up
Kosasih, F. R., Yee, V. T. S., Toh, S. H. Y., & Sündermann, O. (2023) · PLOS Digital Health · doi:10.1371/journal.pdig.0000095 · Cited by 15 · see citing works
Planning for the perfect storm: Perceptions of UK mental health professionals on the increasing impacts of climate change on their service users
Croasdale, K., Grailey, K., Jennings, N. R., Mole, J. A., & Lawrance, E. (2023) · The Journal of Climate Change and Health · doi:10.1016/j.joclim.2023.100253 · Cited by 16 · see citing works
Accelerated transformation programme for healthcare services: structure, function and the lessons learnt
Riley, A. J., Alshammary, S. A., Abuzied, Y., Al-Amer, R. M., Bin-Hussain, I. Z., Alwaalah, M., Alshammari, K. I., & AlQumaizi, K. I. (2023) · BMJ Leader · doi:10.1136/leader-2023-000851 · Cited by 15 · see citing works
Remission From Unhealthy Drinking Among Patients With an Alcohol Use Disorder: A Longitudinal Study Using Systematic, Primary Care–Based Alcohol Screening Data
Palzes, V. A., Kline‐Simon, A. H., Satre, D. D., Sterling, S., Weisner, C. M., & Chi, F. W. (2020) · Journal of Studies on Alcohol and Drugs · doi:10.15288/jsad.2020.81.436 · Cited by 15 · see citing works
“Psychiatric treatment includes assessment, individual and group psychotherapy, and medication management (Lake & Turner, 2017).”
Background
Rising Cognitive Disability as a Public Health Concern Among US Adults
Wong, K., Anderson, C. D., Peterson, C., Bouldin, E. D., Littig, L., Krothapalli, N., Francis, T., Kim, Y., Cucufate, G., Rosand, J. M., et al. (2025) · Neurology · doi:10.1212/wnl.0000000000214226 · Cited by 14 · see citing works
Pilot-Testing of “Healthy Body Healthy Mind”: An Integrative Lifestyle Program for Patients With a Mental Illness and Co-morbid Metabolic Syndrome
Murphy, J., Oliver, G., Ng, C. H., Wain, C., Magennis, J., Opie, R., Bannatyne, A. J., & Sarris, J. J. (2019) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2019.00091 · Cited by 14 · see citing works
“There are calls for an integrated response involving early diagnosis, treatment and management of physical and mental health via lifestyle modification (9).”
Background
Dose–response effects of reported meditation practice on mental‐health and wellbeing: A prospective longitudinal study
Bowles, N. I., & Van Dam, N. T. (2025) · Applied Psychology: Health and Well-Being · doi:10.1111/aphw.70063 · Cited by 15 · see citing works
“While the most established formal practices are typically undertaken in group settings (i.e., Crane et al., 2017), an increasing number of practitioners meditate on their own (Davies et al., 2024; Lake & Turner, 2017; Nagata et al., 2022).”
Facilitators and barriers for implementing the integrated behavioural health care model in the USA : An integrative review
Peer, Y., & Koren, A. (2022) · International Journal of Mental Health Nursing · doi:10.1111/inm.13027 · Cited by 16 · see citing works
Lay community mental health workers (cadres) in Indonesian health services: A qualitative exploration of the views of people with mental health problems and their families
Windarwati, H. D., Susanti, H., Brooks, H. L., Wardani, I. Y., Hasniah, Raya, M., Ati, N. A. L., & Sari, H. (2023) · PLoS ONE · doi:10.1371/journal.pone.0289943 · Cited by 23 · see citing works
Factors influencing medical students and psychiatry residents in Ghana to consider psychiatry as a career option – a qualitative study
Agyapong, V. I. O., Ritchie, A., Doucet, K., Agyapong-Opoku, G., Shalaby, R., Hrabok, M., Ulzen, T., & Osei, A. O. (2020) · Cambridge Prisms Global Mental Health · doi:10.1017/gmh.2020.24 · Cited by 13 · see citing works
“Spending money on improved mental health care will likely increase the interest of medical students in pursuing psychiatry careers as well as decrease the associated socio-economic costs and the number of years a person spends living with a disability (Lake and Turner, 2017).”
Background
Evaluating the Efficacy of a Digital Therapeutic (CT-152) as an Adjunct to Antidepressant Treatment in Adults With Major Depressive Disorder: Protocol for the MIRAI Remote Study
Rothman, B., Slomkowski, M., Speier, A., Rush, A. J., Trivedi, M. H., Lawson, E., Fahmy, M., Carpenter, D., Chen, D., & Forbes, A. (2024) · JMIR Research Protocols · doi:10.2196/56960 · Cited by 12 · see citing works
Understanding the service needs of youth with opioid use: A descriptive study of demographics and co-occurring substance use and mental health concerns
Sverdlichenko, I., Hawke, L. D., & Henderson, J. L. (2021) · Journal of Substance Abuse Treatment · doi:10.1016/j.jsat.2021.108592 · Cited by 12 · see citing works
Mental Health and Psychotropic Stigma Among Student Pharmacists
Davis, B. R., McDaniel, C. C., Wang, C.-H., & Garza, K. B. (2022) · Frontiers in Public Health · doi:10.3389/fpubh.2022.818034 · Cited by 12 · see citing works
“Depression alone causes annual losses in productivity that cost the United States over $31 billion (5).”
Background
Comparing Naturalistic Mental Health Expressions on Student Loan Debts Using Reddit and Twitter
Sinha, G. R., Larrison, C. R., Brooks, I. S., & Kursuncu, U. (2023) · Journal of Evidence-Based Social Work · doi:10.1080/26408066.2023.2202668 · Cited by 12 · see citing works
Cognitive–behavioural versus cognitive–analytic guided self-help for mild-to-moderate anxiety: a pragmatic, randomised patient preference trial
Kellett, S., Bee, C., Smithies, J., Aadahl, V., Simmonds‐Buckley, M., Power, N., Williams, C., Fallon, N., & Delgadillo, J. (2023) · The British Journal of Psychiatry · doi:10.1192/bjp.2023.78 · Cited by 11 · see citing works
“Trial outcomes were benchmarked as broadly equivalent to service outcomes, and effect sizes were also comparable with meta-analysed IAPT outcomes.”
BackgroundMethodInfluential
Engagement and Clinical Improvement Among Older Adult Primary Care Patients Using a Mobile Intervention for Depression and Anxiety: Case Studies
Orr, L. C., Graham, A. K., Mohr, D. C., & Greene, C. J. (2020) · JMIR Mental Health · doi:10.2196/16341 · Cited by 11 · see citing works
“Scarce provider resources and varied geographic, economic, and health factors hinder patients’ability to access treatment [3].”
Background
The effectiveness of social network interventions for psychiatric patients: A systematic review and meta-analysis
Swinkels, L. T. A., Hoeve, M., ter Harmsel, J. F., Schoonmade, L. J., Dekker, J., Popma, A., & van der Pol, T. M. (2023) · Clinical Psychology Review · doi:10.1016/j.cpr.2023.102321 · Cited by 12 · see citing works
Prevalence and distribution of psychological diagnoses and related frequency of consultations in Norwegian urban general practice
Dahli, M. P., Brekke, M., Ruud, T., & Haavet, O. R. (2020) · Scandinavian Journal of Primary Health Care · doi:10.1080/02813432.2020.1783477 · Cited by 11 · see citing works
“There have been concerns that current research and treatment models for mental disorders do not adequately address the complex challenges of mental illness as it is presented in general practice [14] and there have been suggestions to move into more collaborative-type care models [15].”
Background
Involuntary psychiatric treatment and the erosion of consent: A critical discourse analysis of mental health legislation in British Columbia, Canada
Kolar, M., Varcoe, C., Brown, H., & Einboden, R. (2023) · Health An Interdisciplinary Journal for the Social Study of Health Illness and Medicine · doi:10.1177/13634593221096241 · Cited by 10 · see citing works
“This is a costly approach for both the individual, health care system and society, leading to under-treated mental health issues, repeat admissions, and reductions in people seeking help or even avoiding mental health care due to traumatic involuntary treat-ment experiences (Lake and Turner, 2017).”
Background
Social Determinants of Health: An Evaluation of Risk Factors Associated With Inpatient Presentations in the United States
Sulley, S., & Bayssie, M. (2021) · Cureus · doi:10.7759/cureus.13287 · Cited by 11 · see citing works
“This further highlights the need for more focus and investment in mental and behavioral health to mitigate disproportionate health outcomes among these populations [15-18].”
Background
Reducing Readmission of Hospitalized Patients With Depressive Symptoms: A Randomized Trial
Mitchell, S. E., Reichert, M., Martin-Howard, J., Krizman, K., Bragg, A., Huffaker, M., Parker, K., Cawley, M., Roberts, H. W., Sung, Y., et al. (2022) · The Annals of Family Medicine · doi:10.1370/afm.2801 · Cited by 10 · see citing works
Reflecting on Emotions within VR Mood Worlds
Wagener, N., & Niess, J. (2021) · ACM International Joint Conference on Pervasive and Ubiquitous Computing (UbiComp) · doi:10.1145/3460418.3479342 · Cited by 10 · see citing works
“The amount of available services is limited and often there is social stigma attached to seeing a psychotherapist [11, 22].”
Background
Learnings from conducting mental health research during 2004 tsunami in Tamil Nadu, India
Padmavati, R., Raghavan, V., Rera, H., Kearns, M., Rao, K., John, S., & THARA, R. (2020) · BMC Public Health · doi:10.1186/s12889-020-09733-y · Cited by 9 · see citing works
“However, specifics related to research and training are yet to be integrated into practice [22] and address barriers to the commencement of research, such as standardizing ethical guidelines for disaster research and expediting approval from ethical review boards.”
Background
An academic-community interprofessional telehealth online training partnership: Impact on students and providers
Browne, T. A., McKinney, S. H., Duck, L., Baliko, B., Blake, E., Bethel, S. R., & Christopher, R. B. (2021) · Journal of Interprofessional Care · doi:10.1080/13561820.2021.1967896 · Cited by 9 · see citing works
“An interdisciplinary, collaborative approach to the delivery of mental health services is preferred (Happell et al., 2019; Lake & Turner, 2017), to improve client outcomes (Kilbourne et al., 2018) (such as emergency department visits and hospitalizationsGaglioti et al., 2017; Reilly et al., 2013)…”
Background
Contemporary perceptions and meanings of ‘the medical model’ amongst NHS mental health inpatient clinicians
Barnes, G. L., Haghiran, M. Z., & Tracy, D. K. (2022) · International Journal of Mental Health Nursing · doi:10.1111/inm.12972 · Cited by 9 · see citing works
Faith-Based Spiritual Intervention for Persons with Depression: Preliminary Evidence from a Pilot Study
Leung, J., & Li, K. (2023) · Healthcare · doi:10.3390/healthcare11152134 · Cited by 9 · see citing works
“Therefore, there is a pressing need to explore novel evidence-based interventions that can be integrated into existing mental health services to improve access to effective treatment and help individuals achieve better mental health outcomes [7,8].”
Background
Early life risk and resiliency factors and their influences on developmental outcomes and disease pathways: a rapid evidence review of systematic reviews and meta-analyses
Abdul-Hussein, A., Kareem, A., Tewari, S., Bergeron, J., Briollais, L., Challis, J. R. G., Davidge, S. T., Delrieux, C. A., Fortier, I., Goldowitz, D., et al. (2020) · Journal of Developmental Origins of Health and Disease · doi:10.1017/s2040174420000689 · Cited by 9 · see citing works
Evaluation of a Commercial Mobile Health App for Depression and Anxiety (AbleTo Digital+): Retrospective Cohort Study
Anton, M. T., Greenberger, H. M., Andreopoulos, E., & Pande, R. L. (2021) · JMIR Formative Research · doi:10.2196/27570 · Cited by 9 · see citing works
“In addition, even when individuals are able to access traditional face-to-face services, the lag between symptom onset and treatment initiation is, on average, 11 years [6,7].”
Background
Telepsychiatry Netiquette: Connect, Communicate and Consult
Kumar, M. S., Krishnamurthy, S., Dhruve, N., Somashekar, B., & Gowda, M. R. N. (2020) · Indian Journal of Psychological Medicine · doi:10.1177/0253717620958170 · Cited by 8 · see citing works
Mental health innovative solutions in the context of the COVID-19 pandemic
Rocha, A., & Almeida, F. L. (2021) · Journal of Science and Technology Policy Management · doi:10.1108/jstpm-11-2020-0165 · Cited by 8 · see citing works
Mapping the landscape: surf therapy program delivery
Brennan, M., Stain, H. J., & Marshall, J. (2024) · Journal of Outdoor and Environmental Education · doi:10.1007/s42322-023-00152-2 · Cited by 6 · see citing works
“As such, there is increasing interest in alternative and grassroot-based approaches to the 1 3 Journal of Outdoor and Environmental Education (2024) 27:235–254 treatment of mental health across diverse populations and cultures (Lake & Turner, 2017; Thirthalli et al., 2016).”
Caring for critically ill patients with a mental illness: A discursive paper providing an overview and case exploration of the delivery of intensive care to people with psychiatric comorbidity
Flaws, D., Patterson, S., Bagshaw, T., Boon, K., Kenardy, J. A., Sellers, D., & Tronstad, O. (2023) · Nursing Open · doi:10.1002/nop2.1935 · Cited by 7 · see citing works
“Critical care is a domain in which caring for people with mental illness is particularly challenging (Giandinoto & Edward, 2014 , 2015; Kahl & Correll, 2020 ; Lake & Turner, 2017 ; MacNeela et al., 2012 ).”
Smartphone-Based Wellness Assessment Using Mobile Environmental Sensors
McLeod, K., Spachos, P., & Plataniotis, K. N. (2020) · IEEE Systems Journal · doi:10.1109/jsyst.2020.3004558 · Cited by 7 · see citing works
“In the United States, a depressed mood is the leading cause of disability about people aged 15–44 [1].”
Background
Urban-regional disparities in mental health signals in Australia during the COVID-19 pandemic: a study via Twitter data and machine learning models
Wang, S., Zhang, M., Huang, X., Hu, T., Li, Z., Sun, Q. C., & Liu, Y. (2022) · Cambridge Journal of Regions Economy and Society · doi:10.1093/cjres/rsac025 · Cited by 7 · see citing works
AI and mental health: evaluating supervised machine learning models trained on diagnostic classifications
van Oosterzee, A. (2024) · AI & Society · doi:10.1007/s00146-024-02012-z · Cited by 6 · see citing works
“…Collaborators 2022) are shaping to be one of the biggest challenges of our time, especially in low-and middle-income countries, where treatment opportunities are scarce, and in countries where war, conflict, and poverty are aggravating the prevalence of mental disorders (Lake and Turner 2017).”
Physicians' access to primary care: results from the Canadian Medical Association National Physician Health Survey
McFadden, T., Simon, C., Kobeissi, B., & Gérin‐Lajoie, C. (2020) · Canadian Journal of Ophthalmology · doi:10.1016/j.jcjo.2020.03.009 · Cited by 6 · see citing works
A Holistic Client Functioning Profile Comparison of People With Serious Mental Illness
Schmit, M. K., Oller, M. L., Tapia-Fuselier, J. L., & Schmit, E. L. (2020) · Journal of Counseling & Development · doi:10.1002/jcad.12295 · Cited by 6 · see citing works
An Experimental Framework for Wellness Assessment Using the Internet of Things
McLeod, K., Spachos, P., & Plataniotis, K. N. (2020) · IEEE Internet Computing · doi:10.1109/mic.2020.2972817 · Cited by 6 · see citing works
“Poverty is one factor that is linked to mental illness worldwide [3].”
BackgroundInfluential
Integrating Mental Health Support in Emergency Planning and Disaster Risk Mitigation StrategiesPreprint
Kouhirostamkolaei, M. (2023) · Qeios · doi:10.32388/02rtjc · Cited by 7 · see citing works
“[5] Many researchers believe that this kind of support doesn’t respond adequately to mental health chronic issues.[6][2] Severe reactions when they are left unloved can lead to suicidal behaviors, social isolation, and other medical problems that often negatively affect normal activities and could develop into a psych…”
Background
Social media for psychological support of patients with chronic non-infectious diseases: a systematic review
Bert, F., Moro, G. L., Giacomini, G., Minutiello, E., & Siliquini, R. (2023) · Health Promotion International · doi:10.1093/heapro/daad006 · Cited by 5 · see citing works
Digital CBT Interventions Predict Robust Improvements in Anxiety and Depression Symptoms: A Retrospective Database Study
Holley, D., Lubkin, S., Brooks, A., Zaubler, T., & Carney, C. P. (2024) · Innovations in Digital Health Diagnostics and Biomarkers · doi:10.36401/iddb-24-4 · Cited by 5 · see citing works
A Systematic Framework for Analyzing Observation Data in Patient-Centered Registries: Case Study for Patients With Depression
Zolnoori, M., Williams, M. D., Leasure, W. B., Angstman, K. B., & Ngufor, C. G. (2020) · JMIR Research Protocols · doi:10.2196/18366 · Cited by 5 · see citing works
“The majority of patients in the United States, however, do not receive effective mental health care [9].”
The Brain Medicine Clinic: two cases highlighting the advantages of integrative care
Saravi, S. F. B., Mitchell, S. B., & Levitt, S. E. (2023) · BJPsych Open · doi:10.1192/bjo.2022.631 · Cited by 5 · see citing works
Smartphone-delivered multicomponent lifestyle medicine intervention for improving mental health in a nonclinical population: a randomized controlled trial
Wong, V. W.-H., Tong, J. T.-Y., Shi, N.-K., Ng, C. H., Sarris, J. J., & Ho, F. Y. (2024) · Frontiers in Public Health · doi:10.3389/fpubh.2023.1231981 · Cited by 4 · see citing works
Barriers to Cooperation With Family Members in Psychiatric Care in Turkey: Perspectives of Health Professionals and Family Caregivers
Sarı, A., Duman, Z. Ç., & Gül, Y. K. (2021) · Journal of the American Psychiatric Nurses Association · doi:10.1177/10783903211014928 · Cited by 4 · see citing works
“Collaborative care is a care approach in which patients and their families work together systematically to provide patient-centered care (Lake & Turner, 2017).”
Background
Observed behaviours and suicide assessment language post-Mental Health First Aid training in Australia and the United States: a mixed methods study using discourse analysis
Nguyen, W., Moles, R. J., O’Reilly, C. L., Robinson, J. D., Brand-Eubanks, D. C., Kim, A. E., Collins, J. C., & El‐Den, S. (2022) · BMC Medical Education · doi:10.1186/s12909-022-03920-8 · Cited by 4 · see citing works
Navigating the multiple dimensions of the creativity-mental disorder link: a Convergence Mental Health perspective
Angeler, D. G., Smith, E., Berk, M., Ibáñez, A. M., & Eyre, H. A. (2023) · Discover Mental Health · doi:10.1007/s44192-023-00051-4 · Cited by 4 · see citing works
“Although significant mental health promotion and prevention programs are underway [4], these efforts are likely not enough to manage the loss of human capital [5].”
Background
Beyond one-size-fits-all: The rise of personalized treatment in schizophrenia
Nashwan, A. J., & Elawfi, B. (2024) · Personalized Medicine in Psychiatry · doi:10.1016/j.pmip.2024.100118 · Cited by 4 · see citing works
Multidimensional Study of the Attitude towards Euthanasia of Older Adults with Mixed Anxiety-Depressive Disorder
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“Secondly, in many cases, patients may not be offered or subjected to all the necessary treatments [82].”
Background
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“This highlights an urgent need to develop accessible and sustainable mental health interventions for this population group (Lake & Turner, 2017).”
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Chaudhry, M. M., Banta, J. E., McCleary, K., Mataya, R. H., & Banta, J. M. (2022) · International Journal of Mental Health · doi:10.1080/00207411.2022.2123694 · Cited by 4 · see citing works
“There have been calls for major changes in how mental and physical health care is provided (Lake & Turner, 2017) and some attempts to better integrate mental and physical health care, such as within the Veterans Affairs system (Leung et al., 2020).”
Background

Integrating Primary Care and Mental-Health Care: A Commentary on the Collaborative Care Model and the Psychiatry Consultation Clinic Model
Drake, R. E., & Blumberg, J. (2026) · Administration and Policy in Mental Health and Mental Health Services Research · doi:10.1007/s10488-026-01496-9
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Realities of Primary Care Mental Health Integration: Lessons Learned While on the Road
Amin, A. R., Laudermith, A. L., Rodgers-Hannan, O., & Khatkhate, G. (2015) · American Journal of Geriatric Psychiatry · doi:10.1016/j.jagp.2014.12.044
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Self-citation
Integrative mental healthcare White Paper: Establishing a new paradigm through research, education, and clinical guidelines
Sarris, J. J., Glick, R. M., Hoenders, R. H. J., Duffy, J., & Lake, J. (2013) · Advances in Integrative Medicine · doi:10.1016/j.aimed.2012.12.002 · Cited by 30 · see citing works
Self-citation

Authors: Lake, J., & Turner, M. S.
Affiliations: Staff Psychiatrist at the Oakland Medical Center in CA at the time this article was written, and is a founding member and former Chair of the American Psychiatric Association Caucus on Complementary and Alternative Medicine. He is the author of four books on integrative mental health care..
University of California, San Francisco (US)
Venue: The Permanente Journal
Publisher: The Permanente Federation
Published: 2017-12
Volume: 21
Issue: 4
Pages: 17-024
ISSN: 1552-5767 (ISSN-L)
1552-5775
DOI: 10.7812/tpp/17-024
PMC: PMC5593510
OpenAlex: W2743504348
Cited by: 201
References: 48
Citations by year: 2026: 8 · 2025: 13 · 2024: 29 · 2023: 30 · 2022: 32 · 2021: 37 · 2020: 42 · 2019: 9 · 2018: 1
FWCI: 17.64
Type: journal article
Language: en
Open access: bronze
doi.org
Locations: The Permanente Journal (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Topics: Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
Health Sciences › Health Professions › General Health Professions › Interprofessional Education and Collaboration
Keywords: mental health services, collaborative care, primary care integration, complementary and alternative medicine, integrative therapy, mental illness, prevention, Kaiser Permanente, clinician training, cost-effectiveness, severe mental illness
MeSH terms: Complementary Therapies, Mental Disorders, Cooperative Behavior, Cost-Benefit Analysis, Health Services Accessibility, Health Services Research, Humans, Inservice Training, Mental Health Services, Primary Health Care, Telemedicine, Practice Guidelines as Topic, Systems Integration, Patient Safety

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Urgent need for improved mental health care and a more collaborative model of care

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