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E-raamat: Caring for People with Mental Health and Substance Use Disorders in Primary Care Settings: Proceedings of a Workshop

  • Formaat: 122 pages
  • Ilmumisaeg: 30-Dec-2020
  • Kirjastus: National Academies Press
  • Keel: eng
  • ISBN-13: 9780309682718
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  • Formaat: 122 pages
  • Ilmumisaeg: 30-Dec-2020
  • Kirjastus: National Academies Press
  • Keel: eng
  • ISBN-13: 9780309682718

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Behavioral health conditions, which include mental health and substance use disorders, affect approximately 20 percent of Americans. Of those with a substance use disorder, approximately 60 percent also have a mental health disorder. As many as 80 percent of patients with behavioral health conditions seek treatment in emergency rooms and primary care clinics, and between 60 and 70 percent of them are discharged without receiving behavioral health care services. More than two-thirds of primary care providers report that they are unable to connect patients with behavioral health providers because of a shortage of mental health providers and health insurance barriers. Part of the explanation for the lack of access to care lies in a historical legacy of discrimination and stigma that makes people reluctant to seek help and also led to segregated and inhumane services for those facing mental health and substance use disorders.



In an effort to understanding the challenges and opportunities of providing essential components of care for people with mental health and substance use disorders in primary care settings, the National Academies of Sciences, Engineering, and Medicine's Forum on Mental Health and Substance Use Disorders convened three webinars held on June 3, July 29, and August 26, 2020. The webinars addressed efforts to define essential components of care for people with mental health and substance use disorders in the primary care setting for depression, alcohol use disorders, and opioid use disorders; opportunities to build the health care workforce and delivery models that incorporate those essential components of care; and financial incentives and payment structures to support the implementation of those care models, including value-based payment strategies and practice-level incentives. This publication summarizes the presentations and discussion of the webinars.

Table of Contents



Front Matter Proceedings of a Workshop Appendix A: Workshop Statement of Task Appendix B: Virtual Workshop Agenda
Proceedings Of A Workshop 1(1)
Introduction 1(3)
Overview of the Proceedings
3(1)
Models of care for people with Mhsuds
4(17)
Key Elements of Integrated Care
13(1)
Policies to Support Integrated Care
13(3)
Panel Reactions and Discussion
16(3)
Question and Answer Session with the Webinar Participants
19(2)
Closing Remarks of the First Webinar
21(1)
Essential Components Of Care For Three Mhsud Conditions In Primary Care Settings
21(16)
Exploring the Essential Components of Care for Alcohol Use Disorder in Primary Care Settings
21(2)
The Case for Integrating MHSUDs into Primary Care
23(3)
Implementing Collaborative Care Treatment for Depression
26(3)
Sustaining Successful Interventions in Primary Care Practices
29(2)
Panel Reactions and Discussion
31(3)
Question and Answer Session with Webinar Participants
34(3)
Implementation Of Essential Components Of Care In Primary Care Settings
37(16)
Implementing the Essential Components of Care in Primary Pediatric Practices
37(4)
Successful Strategies For Implementing Alcohol SBIRI into Adult Primary Care
41(2)
Integrating Primary Care and Behavioral Health
43(2)
Breaking Down Silos to Improve Integrated Care
45(2)
Panel Reactions and Discussion
47(3)
Question and Answer Session with Webinar Participants
50(2)
Closing Remarks of the Second Webinar
52(1)
Improving The Workforce To Support Providing Essential Components Of Care
53(15)
Developing the Workforce to Support Health Centers
53(1)
The Role of Peer-Support Services in Delivering Collaborative Care to Treat MHSUDs
54(2)
Behavioral Health Workforce to Optimize Medication Outcomes
56(2)
Digital Enhancement of the Primary Care Workforce
58(2)
Supporting a Workforce for the Provision of the Essential Components of Care
60(2)
Panel Reactions and Discussion
62(2)
Question and Answer Session with Webinar Participants
64(4)
Addressing Financing, Payment, Practice, And Systems-Level Issues, Policies, And Incentives To Support Provision Of Essential Components Of Care
68(13)
Can Primary Care Afford Behavioral Health?
68(2)
Delivery System Considerations for Integrating Addiction and Mental Health Treatment into Primary Care Settings
70(2)
Medicare and Medicaid Opportunities and Challenges for Integrating Behavioral Health Care in General Medical Settings
72(3)
The Addiction Recovery Medical Home Model
75(1)
Panel Reactions and Discussion
76(5)
Question and Answer Session with Webinar Participants
81(2)
Closing Remarks 83(1)
References 84(9)
Appendix A Workshop Statement Of Task 93(2)
Appendix B Virtual Workshop Agenda 95