Agrawal Anya, Staab Erin M, Araújo Fabiana S, Desenberg Daily, Laiteerapong Neda
Pritzker School of Medicine, University of Chicago.
Department of Medicine, University of Chicago.
Fam Syst Health. 2024 Dec;42(4):570-581. doi: 10.1037/fsh0000912. Epub 2024 Aug 22.
While studies have described the benefits of integrating behavioral health (BH) into primary care (PC), few have examined patients' perspectives, especially in large, urban health systems. In 2015, the University of Chicago Medicine launched the Primary Care Behavioral Health Integration Program, located in a mental health professional shortage area.
In 2021, semistructured interviews were conducted with adult patients who had discussed their depression symptoms with their primary care clinician (PCC). Participants were asked about their experiences of being screened for depression, discussing BH, and being referred to behavioral health clinicians (BHCs). Interviews were analyzed using thematic analysis and constant comparison, and they were conducted until theme saturation was achieved.
Fifteen participants were interviewed, the majority of whom were women and African American/Black, with an average age of 52. Participants expressed that PC-BH integration helps patients recognize BH problems and navigate the BH care system, emphasizes the connection between physical and mental health, and eases conversations through familiar setting and established trust. Patients enumerated barriers to integration, including barriers to BH care in the PC setting, barriers to BH conversations with PCCs/BHCs, and barriers to referrals to psychiatry/external therapy. Patients highlighted facilitators of integration, including trust with their PCC, collaboration between PCCs and BHCs, and population-level screening.
These perspectives affirm the core strength of PC-BH integration: making BH more accessible and destigmatizing, especially for underserved communities. They also emphasize the importance of collaboration between PCCs and BHCs, shared identities, and actively involving patients in program design and quality improvement interventions. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
虽然已有研究阐述了将行为健康（BH）纳入初级保健（PC）的益处，但很少有研究考察患者的观点，尤其是在大型城市卫生系统中。2015年，芝加哥大学医学中心启动了初级保健行为健康整合项目，该项目位于心理健康专业人员短缺地区。
2021年，对与初级保健临床医生（PCC）讨论过抑郁症状的成年患者进行了半结构化访谈。参与者被问及他们接受抑郁筛查、讨论行为健康以及被转介给行为健康临床医生（BHC）的经历。访谈采用主题分析和持续比较的方法进行，直至达到主题饱和。
共访谈了15名参与者，其中大多数为女性以及非裔美国人/黑人，平均年龄为52岁。参与者表示，初级保健与行为健康的整合有助于患者认识行为健康问题并在行为健康护理系统中顺利就医，强调了身心健康之间的联系，并通过熟悉的环境和已建立的信任使交流更加顺畅。患者列举了整合过程中的障碍，包括初级保健环境中行为健康护理的障碍、与初级保健临床医生/行为健康临床医生进行行为健康交流的障碍以及转介至精神科/外部治疗的障碍。患者强调了整合的促进因素，包括对初级保健临床医生的信任、初级保健临床医生与行为健康临床医生之间的协作以及人群层面的筛查。
这些观点证实了初级保健与行为健康整合的核心优势：使行为健康服务更容易获得且减少污名化，尤其是对服务不足的社区而言。它们还强调了初级保健临床医生与行为健康临床医生之间协作、共享身份认同以及让患者积极参与项目设计和质量改进干预措施的重要性。（《心理学文摘数据库记录》（c）2024美国心理学会，保留所有权利）
