University of South Carolina School of Medicine Greenville, Greenville, SC, USA.
Clemson University College of Behavioral, Social, and Health Sciences, Clemson, SC, USA.
J Prim Care Community Health. 2024 Jan-Dec;15:21501319241275053. doi: 10.1177/21501319241275053.
Behavioral and mental health conditions present significant challenges in the United States where access to care is limited. Family medicine physicians play a crucial role in addressing these challenges, often serving as frontline clinicians for behavioral and mental health conditions.
This study examined the current behavioral and mental health system in a predominantly rural 10-county region in the Southeastern United States through gap analysis in addition to a survey of preparedness and barriers among family medicine physicians in the region.
Gap analysis results indicated that (1) stigma and lack of accessible education about behavioral and mental health, (2) fragmented resources, (3) inaccessible care, and (4) workforce shortage and burnout were primary drivers of poor outcomes in the region. Survey results indicated that physicians feel prepared to treat anxiety and depression but feel less prepared to manage bipolar disorder, schizophrenia, and substance use disorders. Respondents disagreed that there are adequate local resources and referral options for patients with behavioral and mental health conditions. Lack of timely access, distance, cost/insurance status, were all cited by respondents as barriers to appropriate care.
Findings underscore the importance of supporting family medicine physicians to enhance behavioral and mental healthcare outcomes. Behavioral health integration in primary care settings is a promising strategy to improve care accessibility and clinician preparedness. Bridging gaps in health care outcomes requires collaborative efforts, enhanced training, and policy advocacy within the family medicine community to ensure comprehensive and equitable behavioral and mental healthcare delivery.
在美国,行为和心理健康状况带来了巨大的挑战,而获得医疗服务的机会有限。家庭医学医师在应对这些挑战方面发挥着至关重要的作用,他们通常是行为和心理健康问题的一线临床医生。
本研究通过差距分析以及对该地区家庭医学医师的准备情况和障碍进行调查,考察了美国东南部一个以农村为主的 10 个县地区当前的行为和心理健康系统。
差距分析结果表明,(1)对行为和心理健康的污名化和缺乏可及的教育,(2)资源分散,(3)难以获得医疗服务,以及(4)劳动力短缺和倦怠,是该地区不良结果的主要驱动因素。调查结果表明,医生们认为自己有能力治疗焦虑和抑郁,但在管理双相情感障碍、精神分裂症和物质使用障碍方面的准备不足。受访者不同意该地区有足够的针对行为和心理健康问题患者的当地资源和转介选择。缺乏及时的可及性、距离、费用/保险状况等,都是受访者认为的适当护理障碍。
研究结果强调了支持家庭医学医师以改善行为和心理健康医疗结果的重要性。在初级保健环境中进行行为健康整合是改善护理可及性和临床医生准备度的有前途的策略。要弥合医疗保健结果方面的差距,需要家庭医学界内部进行协作努力、加强培训和政策倡导,以确保提供全面和公平的行为和心理健康医疗服务。