Boston Children's Hospital/Harvard Medical School, USA.
Norwegian University of Science and Technology, Trondheim, Norway.
Int Rev Psychiatry. 2022 Feb 17;34(2):101-117. doi: 10.1080/09540261.2022.2059346. Epub 2022 May 4.
The dearth of child and adolescent mental health services (CAMHS) is a global problem. Integrating CAMHS in primary care has been offered as a solution. We sampled integrated care perspectives from colleagues around the world. Our findings include various models of integrated care namely: the stepped care model in Australia; shared care in the United Kingdom (UK) and Spain; school-based collaborative care in Qatar, Singapore and the state of Texas in the US; collaborative care in Canada, Brazil, US, and Uruguay; coordinated care in the US; and, developing collaborative care models in low-resource settings, like Kenya and Micronesia. These findings provide insights into training initiatives necessary to build CAMHS workforce capacity using integrated care models, each with the ultimate goal of improving access to care. Despite variations and progress in implementing integrated care models internationally, common challenges exist: funding within complex healthcare systems, limited training mechanisms, and geopolitical/policy issues. Supportive healthcare policy, robust training initiatives, ongoing quality improvement and measurement of outcomes across programs would provide data-driven support for the expansion of integrated care and ensure its sustainability.
儿童和青少年心理健康服务（CAMHS）的匮乏是一个全球性问题。将 CAMHS 整合到初级保健中已被提议作为一种解决方案。我们从世界各地的同事那里收集了整合照护的观点。我们的发现包括各种整合照护模式，例如：澳大利亚的阶梯式照护模式；英国和西班牙的共同照护；卡塔尔、新加坡和美国德克萨斯州的基于学校的合作性照护；加拿大、巴西、美国和乌拉圭的合作性照护；美国的协调性照护；以及肯尼亚和密克罗尼西亚等资源有限环境下发展合作性照护模式。这些发现为利用整合照护模式来建立 CAMHS 劳动力能力提供了培训计划的见解，最终目标都是为了改善获得照护的机会。尽管国际上在实施整合照护模式方面存在差异和进展，但仍存在共同的挑战：复杂医疗保健系统中的资金、有限的培训机制以及地缘政治/政策问题。支持性的医疗保健政策、强有力的培训计划、持续的质量改进以及对各计划成果的衡量将为整合照护的扩展提供数据支持，并确保其可持续性。
