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Integrated model of primary and mental healthcare for the refugee population served by an academic medical centre

Refugees are at increased risk for developing mental health concerns due to high rates of trauma exposure and postmigration stressors. Moreover, barriers to accessing mental health services result in ongoing suffering within this population. Integrated care—which combines primary healthcare and ment...

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Autores principales: Daniel, Katharine E, Blackstone, Sarah R, Tan, Joseph S, Merkel, Richard L, Hauck, Fern R, Allen, Claudia W
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10083854/
https://www.ncbi.nlm.nih.gov/pubmed/37012045
http://dx.doi.org/10.1136/fmch-2022-002038
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author Daniel, Katharine E
Blackstone, Sarah R
Tan, Joseph S
Merkel, Richard L
Hauck, Fern R
Allen, Claudia W
author_facet Daniel, Katharine E
Blackstone, Sarah R
Tan, Joseph S
Merkel, Richard L
Hauck, Fern R
Allen, Claudia W
author_sort Daniel, Katharine E
collection PubMed
description Refugees are at increased risk for developing mental health concerns due to high rates of trauma exposure and postmigration stressors. Moreover, barriers to accessing mental health services result in ongoing suffering within this population. Integrated care—which combines primary healthcare and mental healthcare into one cohesive, collaborative setting—may improve refugees’ access to comprehensive physical and mental health services to ultimately better support this uniquely vulnerable population. Although integrated care models can increase access to care by colocating multidisciplinary services, establishing an effective integrated care model brings unique logistic (eg, managing office space, delineating roles between multiple providers, establishing open communication practices between specialty roles) and financial (eg, coordinating across department-specific billing procedures) challenges. We therefore describe the model of integrated primary and mental healthcare used in the International Family Medicine Clinic at the University of Virginia, which includes family medicine providers, behavioural health specialists and psychiatrists. Further, based on our 20-year history of providing these integrated services to refugees within an academic medical centre, we offer potential solutions for addressing common challenges (eg, granting specialty providers necessary privileges to access visit notes entered by other specialty providers, creating a culture where communication between providers is the norm, establishing a standard that all providers ought to be CC’ed on most visit notes). We hope that our model and the lessons we have learned along the way can help other institutions that are interested in developing similar integrated care systems to support refugees’ mental and physical health.
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spelling pubmed-100838542023-04-11 Integrated model of primary and mental healthcare for the refugee population served by an academic medical centre Daniel, Katharine E Blackstone, Sarah R Tan, Joseph S Merkel, Richard L Hauck, Fern R Allen, Claudia W Fam Med Community Health Special Communication Refugees are at increased risk for developing mental health concerns due to high rates of trauma exposure and postmigration stressors. Moreover, barriers to accessing mental health services result in ongoing suffering within this population. Integrated care—which combines primary healthcare and mental healthcare into one cohesive, collaborative setting—may improve refugees’ access to comprehensive physical and mental health services to ultimately better support this uniquely vulnerable population. Although integrated care models can increase access to care by colocating multidisciplinary services, establishing an effective integrated care model brings unique logistic (eg, managing office space, delineating roles between multiple providers, establishing open communication practices between specialty roles) and financial (eg, coordinating across department-specific billing procedures) challenges. We therefore describe the model of integrated primary and mental healthcare used in the International Family Medicine Clinic at the University of Virginia, which includes family medicine providers, behavioural health specialists and psychiatrists. Further, based on our 20-year history of providing these integrated services to refugees within an academic medical centre, we offer potential solutions for addressing common challenges (eg, granting specialty providers necessary privileges to access visit notes entered by other specialty providers, creating a culture where communication between providers is the norm, establishing a standard that all providers ought to be CC’ed on most visit notes). We hope that our model and the lessons we have learned along the way can help other institutions that are interested in developing similar integrated care systems to support refugees’ mental and physical health. BMJ Publishing Group 2023-04-03 /pmc/articles/PMC10083854/ /pubmed/37012045 http://dx.doi.org/10.1136/fmch-2022-002038 Text en © Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) .
spellingShingle Special Communication
Daniel, Katharine E
Blackstone, Sarah R
Tan, Joseph S
Merkel, Richard L
Hauck, Fern R
Allen, Claudia W
Integrated model of primary and mental healthcare for the refugee population served by an academic medical centre
title Integrated model of primary and mental healthcare for the refugee population served by an academic medical centre
title_full Integrated model of primary and mental healthcare for the refugee population served by an academic medical centre
title_fullStr Integrated model of primary and mental healthcare for the refugee population served by an academic medical centre
title_full_unstemmed Integrated model of primary and mental healthcare for the refugee population served by an academic medical centre
title_short Integrated model of primary and mental healthcare for the refugee population served by an academic medical centre
title_sort integrated model of primary and mental healthcare for the refugee population served by an academic medical centre
topic Special Communication
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10083854/
https://www.ncbi.nlm.nih.gov/pubmed/37012045
http://dx.doi.org/10.1136/fmch-2022-002038
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