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中西部社区健康中心的初级保健与行为健康服务整合述评:一项混合方法研究。

Commentary on Integration of primary care and behavioral health services in Midwestern community health centers: A mixed methods study.

机构信息

Department of Pediatrics.

出版信息

Fam Syst Health. 2022 Jun;40(2):286-287. doi: 10.1037/fsh0000712.

DOI:10.1037/fsh0000712
PMID:35666899
Abstract

Comments on the original article by Staab et al. (see record 2022-14598-001) regarding the integration of primary care and behavioral health services in Midwestern community health centers. As a clinician, the author identifies with many of the findings in Staab et al.'s paper. Limited resources related to patient access were cited as a barrier to integration. In the academic medical center and the larger community, we have experienced too few behavioral health providers (BHPs) to meet the increasing demand for behavioral health (BH) services. There are long waitlists for BH care, and patients report difficulty accessing appropriate BH resources. A lack of funding within the health care system has been a barrier to hiring an adequate BH workforce to meet the demand of internal and external BH referrals. Integrated care requires a specific set of skills and training experiences to competently provide brief interventions and work as part of an interdisciplinary medical team in a fast-paced medical setting. The pool of qualified applicants for integrated care positions is limited, challenging recruitment efforts. Another factor reducing access within the integrated care setting is difficulty adhering to a short-term treatment model with patients who have severe mental health issues and long-term therapy needs, given their difficulty obtaining longer-term services. Unlike the majority of community health centers (CHCs) in this study, we have insufficient social work support to adequately meet all patients' care management needs. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

摘要

对 Staab 等人(参见记录 2022-14598-001)关于中西部社区卫生中心的初级保健和行为健康服务整合的原始文章的评论。作为一名临床医生,作者认同 Staab 等人论文中的许多发现。与患者获得相关的有限资源被认为是整合的障碍。在学术医疗中心和更大的社区中,我们的行为健康提供者(BHP)太少,无法满足不断增长的行为健康(BH)服务需求。BH 护理的候补名单很长,患者报告难以获得适当的 BH 资源。医疗保健系统内缺乏资金一直是招聘足够的 BH 劳动力以满足内部和外部 BH 转介需求的障碍。综合护理需要一套特定的技能和培训经验,以胜任在快节奏的医疗环境中提供简短干预和作为跨学科医疗团队的一部分工作。合格的综合护理职位申请人人数有限,这对招聘工作构成了挑战。另一个在综合护理环境中降低可及性的因素是,对于那些有严重精神健康问题和长期治疗需求的患者,很难遵循短期治疗模式,因为他们难以获得长期服务。与本研究中的大多数社区卫生中心(CHC)不同,我们的社会工作支持不足,无法充分满足所有患者的护理管理需求。(PsycInfo 数据库记录(c)2022 APA,保留所有权利)。

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