Skip to main content

Advertisement

SpringerLink
Log in

Recommendations for Primary Care Provided by Psychiatrists

  • Original Paper
  • Published:
Community Mental Health Journal Aims and scope Submit manuscript

Abstract

Recent studies have shown that people with severe mental illness have a dramatically lower life expectancy than the general population. Psychiatrists have not traditionally been very attentive to or involved with physical health issues and there has been growing emphasis on integrated care for physical and mental health and access to primary care for all members of the population. This paper examines the role of psychiatrists in the provision of primary care to the patients they treat. Some recommendations are offered for their involvement in the provision of primary care at three levels of complexity: Level 1—Universal Basic Psychiatric Primary Care; Level 2—Enhanced Psychiatric Primary Care; and Level 3—Fully Integrated Primary Care and Psychiatric Management. Some of the obstacles to the provision of primary care by psychiatrists are considered along with some suggestions for overcoming them.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Alakeson, V., Frank, R. G., & Katz, R. E. (2010). Specialty care medical homes for people with severe, persistent mental disorders. Health Affairs (Project Hope), 20, 867–873.

    Article  Google Scholar 

  • Bland, D. A., Lambert, K., & Raney, L. (2014). Resource document on risk management and liability issues in integrated care models. The American Journal of Psychiatry, 171(5), 1–7.

    Article  PubMed  Google Scholar 

  • Butler, M., Kane, R. L., McAlpine, D., Kathol, R. G., Fu, S. S., Hagedorn, H., & Wilt, T. J. (2008). Integration of mental health/substance abuse and primary care no. 173 (Prepared by the Minnesota Evidence-based Practice Center under Contract No. 290-02-0009.) AHRQ publication no. 09E003. Rockville, MD.: Agency for Healthcare Research and Quality.

  • Cerimele, J. M., & Strain, J. J. (2010). Integrating primary care services into psychiatric care settings: A review of the literature. Primary Care Companion to the Journal of Clinical Psychiatry, 12(6), e1–e4.

    Google Scholar 

  • Collins, C., Hewson, D. L., Munger, R., & Wade, T. (2010). Evolving models of behavioral health integration in primary care. Milbank Memorial Fund. Retrieved from http://www.milbank.org/uploads/documents/10430EvolvingCare/EvolvingCare.pdf.

  • Croft, B., & Parish, S. L. (2013). Care integration in the Patient Protection and Affordable Care Act: Implications for behavioral health. Administration and Policy in Mental Health and Mental Health Services Research, 40(4), 258–263.

    Article  PubMed  Google Scholar 

  • Deegan, P. (2010). A web application to support recovery and shared decision making in psychiatric medication clinics. Psychiatric Rehabilitation Journal, 34(1), 23–28.

    Article  PubMed  Google Scholar 

  • Dougherty, W. J., McDaniel, S. H., & Baird, M. A. (1996). Five levels of primary care/behavioral healthcare collaboration. Behavioral Healthcare Tomorrow, 5(5), 25–28.

    Google Scholar 

  • Druss, B. G., Esenwein, S. A., Compton, M. T., Zhao, L., & Leslie, D. L. (2011). Budget impact and sustainability of medical care management for persons with serious mental illnesses. American Journal of Psychiatry, 168, 1171–1178.

    Article  PubMed  PubMed Central  Google Scholar 

  • Druss, B. G., & Mauer, B. J. (2010). Health care reform and care at the behavioral health–primary care interface. Psychiatric Services, 61, 1087–1092.

    Article  PubMed  Google Scholar 

  • Druss, B. G., Rohrbaugh, R. M., Levinson, C. M., & Rosenheck, R. A. (2001). Integrated medical care for patients with serious psychiatric illness: A randomized trial. Archives of General Psychiatry, 58(9), 861–868.

    Article  CAS  PubMed  Google Scholar 

  • Golomb, B., Pyne, J., Wright, B., Jaworski, B., Lohr, J. B., & Bozzette, S. (2000). The role of psychiatrists in primary care of patients with severe mental illness. Psychiatric Services, 51(6), 766–773.

    Article  CAS  PubMed  Google Scholar 

  • Hert, M., Cohen, D., Bobes, J., Cetkovich-Bakmas, M., Leucht, S., Ndetei, D., & Correll, C. (2011). Physical illness in patients with severe mental disorders. II. Barriers to care, monitoring and treatment guidelines, plus recommendations at the system and individual level. World Psychiatry, 10(2), 138–151.

    Article  PubMed  Google Scholar 

  • Hunter, C. L., & Goodie, J. L. (2010). Operational and clinical components for integrated-collaborative behavioral healthcare in the patient-centered medical home. Families, Systems, & Health, 28(4), 308–321.

    Article  Google Scholar 

  • Kates, N., Craven, M., Crustolo, A. M., Nikolaou, L., & Allen, C. (1987). Integrating mental health services within primary care: A Canadian program. General Hospital Psychiatry, 19(5), 324–332.

    Article  Google Scholar 

  • Katon, W. J., Lin, E. H., Von Korff, M., Ciechanowski, P., Ludman, E. J., Young, B., & McCulloch, D. (2010). Collaborative care for patients with depression and chronic illnesses. New England Journal of Medicine, 363(27), 2611–2620.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Katon, W., & Unutzer, J. (2011). Conulstation psychiatry in the medical home and accountable care organizations: Achieving the triple aim. General Hospital Psychiatry, 33(4), 305–310.

    Article  PubMed  PubMed Central  Google Scholar 

  • Kisely, S., Duerden, D., Shaddick, S., & Jayabarathan, A. (2006). Collaboration between primary care and psychiatric services: Does it help family physicians? Canadian Family Physician, 52(7), 876–877.

    PubMed  Google Scholar 

  • Marder, S. R., Essock, S. M., Miller, A. L., et al. (2004). Physical health monitoring of patients with schizophrenia. American Journal of Psychiatry, 161, 1334–1349.

    Article  PubMed  Google Scholar 

  • Mechanic, D. (2012). Seizing opportunities under the Affordable Care Act for transforming the mental and behavioral health system. Health Affairs, 31(2), 376–382.

    Article  PubMed  Google Scholar 

  • Mercer, S. W., Gunn, J., Bower, P., Wyke, S., & Guthrie, B. (2012). Managing patients with mental and physical multimorbidity. BMJ, 345, e5559.

    Article  PubMed  Google Scholar 

  • Miller, C. L., Druss, B. G., Dombrowski, E. A., & Rosenheck, R. A. (2003). Barriers to primary medical care among patients at a community mental health center. Psychiatric Services., 54(8), 1158–1160.

    Article  Google Scholar 

  • NYS Center of Excellence for Cultural Competence. (2010) Improving the physical health of people with serious mental illness: A systematic review of lifestyle interventions: A Report from the NYS Center of Excellence for Cultural Competence at the New York State Psychiatric Institute. New York, NY.

  • Parks, J. (2007). Implementing practice guidelines: Lessons from public mental health settings. Journal of Clinical Psychiatry, 68(suppl 4), 45–48.

    PubMed  Google Scholar 

  • Phelan, M., Stradins, L., & Morrison, S. (2001). Physical health of people with severe mental illness. BMJ, 322, 443–444.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Pincus, H. A. (1987). Patient-oriented models for linking primary care and mental health care. General Hospital Psychiatry, 9(2), 95–101.

    Article  CAS  PubMed  Google Scholar 

  • Pollack, D. A., Raney, L. E., & Vanderlip, E. R. (2012). Integrated care and psychiatrists. In H. McQuistion, W. Sowers, J. Ranz & J. Feldman (Eds.), Handbook of Community Psychiatry. New York: Springer Publication.

    Google Scholar 

  • Pomerantz, A. S., & Sayers, S. L. (2010). Primary care-mental health integration in healthcare in the Department of Veterans Affairs. Families, Systems, & Health, 28(2), 78–82.

    Article  Google Scholar 

  • Sani, K. M. (2006). Monitoring the physical health of psychiatric patients on psychotropic drugs. Psychiatric Bulletin, 30, 468–469.

    Article  Google Scholar 

  • Shore, J. H. (1996). Psychiatry at a crossroad: Our role in primary care. American Jornal of Psychiatry, 153(11), 1398–1403.

    Article  CAS  Google Scholar 

  • Strathdee, G. (1987). Primary care—Psychiatry interaction: A British perspective. General Hospital Psychiatry, 9(2), 102–110.

    Article  CAS  PubMed  Google Scholar 

  • Tanielian, T., Pincus, H. A., Dietrich, A. J., et al. (2000). Referrals to Psychiatrists: Assessing the communication interface between psychiatry and primary care. Psychosomatics, 41(3), 245–252.

    Article  CAS  PubMed  Google Scholar 

  • Unützer, J., Chan, Y. F., Hafer, E., Knaster, J., Shields, A., Powers, D., & Veith, R. C. (2012). Quality improvement with pay-for-performance incentives in integrated behavioral health care. American Journal of Public Health, 102(6), e41–e45.

    Article  PubMed  PubMed Central  Google Scholar 

  • Vreeland, B. (2007). Bridging the gap between mental and physical health: A multidisciplinary approach. Journal of Clinical Psychiatry, 68(suppl 4), 26–33.

    PubMed  Google Scholar 

  • Whooley, M. A. (2006). Depression and cardiovascular disease: Healing the broken-hearted. JAMA, 295(24), 2874–2881.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Woltmann, E., Grogan-Kaylor, A., Perron, B., Georges, H., Kilbourne, A. M., & Bauer, M. (2012). Comparative effectiveness of collaborative chronic care models for mental health conditions across primary, specialty, and behavioral health care settings: Systematic review and meta-analysis. American Journal of Psychiatry, 169(8), 790–804.

    Article  PubMed  Google Scholar 

  • Zivin, K., Pfeiffer, P. N., Szymanski, B. R., Valenstein, M., Post, E. P., Miller, E. M., & McCarthy, J. F. (2010). Initiation of primary care—Mental health integration programs in the VA health system: Associations with psychiatric diagnoses in primary care. Medical Care, 48(9), 843–851.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, 3811 O’Hara St, Webster Hall, Pittsburgh, PA, 15213, USA

    Wesley Sowers

  2. Department of Psychiatry, New York State Psychiatric Institute, Columbia University Medical Center, 1051 Riverside Drive, Box 103, New York, NY, 10032, USA

    Melissa Arbuckle

  3. Sunflower State Health Plan Columbia, University of Missouri Medical Center, 4507 Maxwell Lane, Columbia, MO, 65203-6565, USA

    Sosunmolu Shoyinka

Authors
  1. Wesley Sowers
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Melissa Arbuckle
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Sosunmolu Shoyinka
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Wesley Sowers.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Sowers, W., Arbuckle, M. & Shoyinka, S. Recommendations for Primary Care Provided by Psychiatrists. Community Ment Health J 52, 379–386 (2016). https://doi.org/10.1007/s10597-015-9983-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10597-015-9983-0

Keywords

Search

Navigation