Georgetown University Medical Center, 2115 Wisconsin Avenue NW, Washington, DC 20007, USA.
Am J Orthopsychiatry. 2011 Oct;81(4):543-51. doi: 10.1111/j.1939-0025.2011.01125.x.
Low-income, uninsured immigrants are burdened by poverty and a high prevalence of trauma exposure and thus are vulnerable to mental health problems. Disparities in access to mental health services highlight the importance of adapting evidence-based interventions in primary care settings that serve this population. In 2005, the Montgomery Cares Behavioral Health Program began adapting and implementing a collaborative care model for the treatment of depression and anxiety disorders in a network of primary care clinics that serve low-income, uninsured residents of Montgomery County, Maryland, the majority of whom are immigrants. In its 6th year now, the program has generated much needed knowledge about the adaptation of this evidence-based model. The current article describes the adaptations to the traditional collaborative care model that were necessitated by patient characteristics and the clinic environment.
低收入、无保险的移民深受贫困和创伤暴露率高的困扰，因此容易出现心理健康问题。在获得心理健康服务方面的差异突出表明，必须在为这部分人群服务的初级保健环境中调整基于证据的干预措施。2005 年，蒙哥马利关怀行为健康计划开始调整并实施合作性护理模式，以治疗马里兰州蒙哥马利县低收入、无保险的初级保健诊所网络中的抑郁症和焦虑症患者，其中大多数是移民。该计划现在已经进入第 6 个年头，为这一基于证据的模式的调整提供了急需的知识。本文介绍了为适应患者特征和诊所环境而对传统合作性护理模式进行的调整。
