Integration of behavioral health services in a primary care clinic serving rural appalachia: Reflections on a clinical experience

Families, Systems and Health

Volumn 29, Issue 4, 2011, Pages 291-302

  Correll, Jennifer A ^a   Cantrell, Peggy ^a   Dalton III, William T ^a  

^a EAST TENNESSEE STATE UNIVERSITY   (United States)

Author keywords

Behavioral health; Depression; Primary care; Rural; Training

Indexed keywords

ARTICLE; CLINICAL COMPETENCE; CLINICAL PROTOCOL; CURRICULUM; DEPRESSION; HEALTH CARE DELIVERY; HEALTH SERVICE; HUMAN; INTEGRATED HEALTH CARE SYSTEM; MENTAL HEALTH SERVICE; METHODOLOGY; ORGANIZATION AND MANAGEMENT; OUTPATIENT DEPARTMENT; PRIMARY HEALTH CARE; PSYCHOMETRY; QUESTIONNAIRE; RURAL POPULATION; UNITED STATES;

APPALACHIAN REGION; CLINICAL COMPETENCE; CLINICAL PROTOCOLS; CURRICULUM; DELIVERY OF HEALTH CARE, INTEGRATED; DEPRESSION; HEALTH SERVICES ACCESSIBILITY; HEALTH SERVICES NEEDS AND DEMAND; HUMANS; MENTAL HEALTH SERVICES; OUTPATIENT CLINICS, HOSPITAL; PRIMARY HEALTH CARE; PSYCHOMETRICS; QUESTIONNAIRES; RURAL POPULATION; TENNESSEE;

EID: 84860615874     PISSN: 10917527     EISSN: None     Source Type: Journal    
DOI: 10.1037/a0026303     Document Type: Article

References (22)

1. American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders Fourth Edition, Text Revision. Arlington, VA: American Psychiatric Association.
2. Appalachian Regional Commission (Cartographer). (2009). Subregions in Appalachia (Geographical Map). Retrieved from http:// www.arc.gov/research/MapsofAppalachia.asp ?MAP_ID
3. Areán, P. A., Ayalon, L., Jin, C., McCulloch, C. E., Linkins, K., Chen, H., ...Estes, C. (2008). Integrated specialty mental health care among older minorities improves access but not outcomes: Results of the PRISMe study. International Journal of Geriatric Psychiatry, 23, 1086-1092. doi:10.1002/gps.2100
4. Arroll, B., Goodyear-Smith, F., Crengle, S., Gunn, J., Kerse, N., Fishman, T., ...Hatcher, S. (2010). Validation of PHQ-2 and PHQ-9 to screen for major depression in the primary care population. Annals of Family Medicine, 8(4), 348-53. doi:10.1370/afm.1139
5. Blount, A., & Bayona, J. (1994). Towards a system of integrated care. Family Systems Medicine, 12, 171-182. doi:10.1037/h0089151
6. Blount, A. (2003). Integrated primary care: Organizing the evidence. Families, Systems, & Health, 21, 121-133. doi:10.1037/1091-7527.21.2.121
7. Fickel, J. J., Parker, L. E., Yano, E. M., & Kirchner, J. E. (2007). Primary care-mental health collaboration: An example of assessing usual practice and potential barriers. Journal of Interprofessional Care, 21, 207-216. doi:10.1080/ 13561820601132827
8. Gunn, W. B., & Blount, A. (2009). Primary care mental health: A new frontier for psychology. Journal of Clinical Psychology, 65, 235-252. doi:10.1002/jclp.20499
9. Katon, W., Robinson, P., Von Korff, M., Lin, E., Bush, T., Ludman, E., ... Walker, E. (1996). A multifaceted intervention to improve treatment of depression in primary care. Archives of General Psychiatry, 53, 924-932.
10. Kroenke, K., Spitzer, R. L., & Williams, J. (2001). The PHQ-9: Validity of a brief depression severity measure. Journal of General Internal Medicine, 16, 606-613. doi:10.1046/j.1525-1497.2001.016009606.x
11. Kroenke, K., Spitzer, R. L., & Williams, J. (2003). The Patient Health Questionnaire-2: Validity of a two-item depression screener. Medical Care, 41, 1284-1292. doi:10.1097/01.MLR.0000093487.78664.3C
12. Levant, R. F., House, A. T., May, S., & Smith, R. (2006). Cost offset: Past, present, and future. Psychological Services, 3, 195-207. doi:10.1037/1541-1559.3.3.195
13. Löwe, B., Kroenke, K., Herzog, W., & Grafe, K. (2004). Measuring depression outcome with a brief self-report instrument: Sensitivity to change of the Patient Health Questionnaire (PHQ-9). Journal of Affective Disorders, 81, 61-66. doi:10.1016/S0165-0327(03)00198-8
14. Probst, J. C., Laditka, S. B., Moore, C. G., Huran, N., Powell, M. P., & Baxley, E. G. (2006). Rural-Urban differences in depression prevalence: Implications for family medicine. Family Medicine, 38, 653-660.
15. Rainer, J. P. (2010). The road much less traveled: Treating rural and isolated clients. Journal of Clinical Psychology, 66, 475-489. doi:10.1002/jclp.20680
16. Rowan, A. B., & Runyan, C. N. (2005). A primer on the consultation model of primary care behavioral health integration. In L. C. James & R. A. Folen (Eds.), The primary care consultant: The next frontier for psychologists in hospitals and clinics (pp. 9-27). Washington, DC: American Psychological Association. doi:10.1037/10962-001
17. Smalley, K. B., Yancey, C. T., Warren, J. C., Naufel, K., Ryan, R., & Pugh, J. L. (2010). Rural mental health and psychological treatment: A review for practitioners. Journal of Clinical Psychology, 66, 479-489. doi:10.1002/jclp.20688
18. Spitzer, R. L., Kroenke, K., & Williams, J. B. (1999). Validation and utility of a self-report version of the prime-MD: The PHQ primary care study. Primary Care Evaluation of Mental Disorders. Patient Health Questionnaire. Journal of the American Medical Association, 282, 1737-1744. doi:10.1001/jama.282.18.1737
19. Strosahl, K. (1996). Confessions of a behavior therapist in primary care: The odyssey and the ecstasy. Cognitive and Behavioral Practice, 3, 1-28. doi:10.1016/S1077-7229(96)80028-9
20. Substance Abuse and Mental Health Services Administration. (2009). State-by-state report shows substantial disparities: Data show substance abuse and mental illness challenges affect all states. SAMSHA News, 17, 10-12. Retrieved from www.samhsa.gov/ samhsaNewsletter/Volume_17_Number_4/ JulyAugust2009.pdf
21. Swinton, J.J., Robinson, W.D., & Bischoff, R.J. (2009). Telehealth and rural depression: Physician and patient perspectives. Families, Systems, & Health, 27, 127-182.
22. United States Department of Health and Human Services. (2010). Find shortage areas: HPSA by state and county. Retrieved from http:// hpsafind.hrsa.gov/