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Integrating physical and mental healthcare: Facilitators and barriers to success
INTRODUCTION: Effective and appropriate provision of mental healthcare has long been a struggle globally, resulting in significant disparity between prevalence of mental illness and access to care. One attempt to address such disparity was the Patient Protection and Affordable Care Act (PPACA), 2010...
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
SAGE Publications
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9413608/ https://www.ncbi.nlm.nih.gov/pubmed/36204502 http://dx.doi.org/10.1177/23992026211050615 |
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author | Monaghan, Karen Cos, Travis |
author_facet | Monaghan, Karen Cos, Travis |
author_sort | Monaghan, Karen |
collection | PubMed |
description | INTRODUCTION: Effective and appropriate provision of mental healthcare has long been a struggle globally, resulting in significant disparity between prevalence of mental illness and access to care. One attempt to address such disparity was the Patient Protection and Affordable Care Act (PPACA), 2010, mandate in the United States to integrate physical and mental healthcare in Federally Qualified Health Centers (FQHCs). The notion of integration is attractive, as it has demonstrated the potential to improve both access to mental healthcare and healthcare outcomes. However, while the PPACA mandate set this requirement for FQHCs, no clear process as to how these centers should achieve successful integration was identified. METHODS: This research employed case study methods to examine the implementation of this policy in two FQHCs in New England. Data were obtained from in-depth interviews with leadership, management, and frontline staff at two case study sites. RESULTS: Study findings include multiple definitions of and approaches for integrating physical and mental healthcare, mental healthcare being subsumed into, rather than integrated with, the medical model and multiple facilitators of and barriers to integration. CONCLUSION: This study asked questions about what integration means, how it occurs, and what factors facilitate or pose barriers to integration. Integration is facilitated by co-location of providers within the same department, a warm hand-off, collaborative collegial relationships, strong leadership support, and a shared electronic health record. However, interdisciplinary conflict, power differentials, job insecurity, communication challenges, and the subsumption of mental health into the medical model pose barriers to successful integration. |
format | Online Article Text |
id | pubmed-9413608 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | SAGE Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-94136082022-10-05 Integrating physical and mental healthcare: Facilitators and barriers to success Monaghan, Karen Cos, Travis Med Access Point Care Research @ Point of Care INTRODUCTION: Effective and appropriate provision of mental healthcare has long been a struggle globally, resulting in significant disparity between prevalence of mental illness and access to care. One attempt to address such disparity was the Patient Protection and Affordable Care Act (PPACA), 2010, mandate in the United States to integrate physical and mental healthcare in Federally Qualified Health Centers (FQHCs). The notion of integration is attractive, as it has demonstrated the potential to improve both access to mental healthcare and healthcare outcomes. However, while the PPACA mandate set this requirement for FQHCs, no clear process as to how these centers should achieve successful integration was identified. METHODS: This research employed case study methods to examine the implementation of this policy in two FQHCs in New England. Data were obtained from in-depth interviews with leadership, management, and frontline staff at two case study sites. RESULTS: Study findings include multiple definitions of and approaches for integrating physical and mental healthcare, mental healthcare being subsumed into, rather than integrated with, the medical model and multiple facilitators of and barriers to integration. CONCLUSION: This study asked questions about what integration means, how it occurs, and what factors facilitate or pose barriers to integration. Integration is facilitated by co-location of providers within the same department, a warm hand-off, collaborative collegial relationships, strong leadership support, and a shared electronic health record. However, interdisciplinary conflict, power differentials, job insecurity, communication challenges, and the subsumption of mental health into the medical model pose barriers to successful integration. SAGE Publications 2021-10-11 /pmc/articles/PMC9413608/ /pubmed/36204502 http://dx.doi.org/10.1177/23992026211050615 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). |
spellingShingle | Research @ Point of Care Monaghan, Karen Cos, Travis Integrating physical and mental healthcare: Facilitators and barriers to success |
title | Integrating physical and mental healthcare: Facilitators and barriers
to success |
title_full | Integrating physical and mental healthcare: Facilitators and barriers
to success |
title_fullStr | Integrating physical and mental healthcare: Facilitators and barriers
to success |
title_full_unstemmed | Integrating physical and mental healthcare: Facilitators and barriers
to success |
title_short | Integrating physical and mental healthcare: Facilitators and barriers
to success |
title_sort | integrating physical and mental healthcare: facilitators and barriers
to success |
topic | Research @ Point of Care |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9413608/ https://www.ncbi.nlm.nih.gov/pubmed/36204502 http://dx.doi.org/10.1177/23992026211050615 |
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