Of identified patients with behavioral or conduct problems, 22% were referred to an external mental health provider. At 6-month follow-up, more than a third (39%) had not attended an appointment with the referred provider, suggesting many behavioral problems identified in primary care
are left untreated. Subclinical or subthreshold disruptive, externalizing behavioral problems are also common among children who do not meet criteria for diagnosable disorders (Leflot et al., 2011 and Leijten et al., 2013). These children may present with problematic behaviors such as temper tantrums or disobedience. For both BEZ235 in vivo diagnosable and subthreshold concerns, caregivers often utilize pediatricians as a resource for mental health care. Although pediatricians and other medical providers typically feel responsible for managing such mental health
issues (Stein et al., 2008), they are not often trained to adequately address these difficulties (Axelrad, Pendley, Miller, & Tynan, 2008). In order to address the mental health needs seen in primary care, medical and psychological services have increasingly been blended into an integrated model of health care delivery. This model aims to assist people with their behavioral health concerns at the time of their medical visits, avoiding the lag between an identified mental health need and its treatment (Strosahl, 1998). Effective service NVP-AUY922 delivery in an integrated primary care model calls for medroxyprogesterone the joining of a variety of professionals working collaboratively as a team (Bachrach, 1996 and Blount, 2003). Patients across the lifespan—including families—are granted access to psychological services when they present to their primary care providers for medical concerns. The philosophy of integrated care differs from traditional mental health care in important ways. For instance, the goal of treatment is functional improvement of the patient rather than symptom amelioration. Furthermore,
behavioral health service providers are viewed as an integral member of the medical health team (Robinson & Reiter, 2007) and, therefore, patient rapport with their primary care provider (PCP) often assists in quick building of rapport with the mental health provider. In the integrated care model, behavioral health problems identified during a PCP visit trigger an in-the-moment referral to a BHC, also called a “warm hand-off.” BHCs will often conduct their interventions right in the medical examination room, so patients do not need to change locations or feel increased stigma for visiting with a BHC and discussing behavioral health concerns. The mechanics of service delivery in an integrated behavioral health care model also differ from traditional care.
Kwa wale waliopatikana na matatizo ya tabia, asilimia 22 walielekezwa kwa mtoa huduma wa afya ya akili. Katika uchunguzi wa miezi sita, zaidi ya theluthi (39%) hawakuhudhuria miadi na mtoa huduma aliyewasilishwa, ikidokeza matatizo mengi ya tabia yaliyotambuliwa katika huduma ya msingi hayatibiwa. Subclinical au subthreshold disruptive, externalizing tabia matatizo ni pia kawaida miongoni mwa watoto ambao si kukidhi vigezo kwa ajili ya magonjwa ya kugundua (Leflot et al., 2011 na Leyden et al., 2013). Watoto hao wanaweza kuwa na tabia zenye matatizo kama vile hasira kali au kutotii. Kwa wasiwasi wa BEZ235 in vivo na wasiwasi wa chini ya kizingiti, watunzaji mara nyingi hutumia madaktari wa watoto kama rasilimali ya huduma ya afya ya akili. Ingawa madaktari wa watoto na watoa huduma nyingine za matibabu kwa kawaida wanahisi kuwa na jukumu la kusimamia masuala kama hayo ya afya ya akili (Stein et al., 2008), mara nyingi hawafundishwi kushughulikia shida hizi kwa kutosha (Axelrad, Pendley, Miller, & Tynan, 2008). Ili kukabiliana na mahitaji ya afya ya akili inayoonekana katika huduma ya msingi, huduma za matibabu na kisaikolojia zimekuwa zikiongezeka katika mfano wa ushirikiano wa utoaji wa huduma za afya. Mfano huu unakusudia kusaidia watu na wasiwasi wao wa afya ya tabia wakati wa ziara zao za matibabu, kuepuka kuchelewa kati ya mahitaji ya afya ya akili yaliyotambuliwa na matibabu yake (Strosahl, 1998). Kwa mfano, katika NVPA, huduma ya msingi ya matibabu ya msingi ya matibabu ya msingi ya msingi ya msingi ya msingi ya msingi ya msingi ya msingi ya msingi ya msingi ya msingi ya msingi ya msingi ya msingi ya msingi ya msingi ya msingi ya msingi ya msingi ya msingi ya msingi ya msingi ya msingi ya msingi ya msingi ya msingi (Bachrach, Bachrach, Bachrach, Bachrach, Bachrach, Bachrach). Wagonjwa katika muda wote wa maisha - ikiwa ni pamoja na familia - wanapewa upatikanaji wa huduma za kisaikolojia wanapowasilisha kwa watoa huduma zao za msingi kwa wasiwasi wa matibabu. Falsafa ya utunzaji wa pamoja inatofautiana na utunzaji wa jadi wa afya ya akili kwa njia muhimu. Kwa mfano, lengo la matibabu ni kuboresha utendaji wa mgonjwa badala ya kupunguza dalili. Kwa kuongezea, watoa huduma za afya ya tabia huonekana kama mwanachama muhimu wa timu ya afya ya matibabu (Robinson & Reiter, 2007), na kwa hivyo, uhusiano wa mgonjwa na mtoa huduma yao wa msingi (PCP) mara nyingi husaidia katika kujenga haraka uhusiano na mtoa huduma ya afya ya akili. Katika mfumo wa utunzaji wa pamoja, matatizo ya afya ya tabia yaliyotambuliwa wakati wa ziara ya PCP husababisha kuelekezwa kwa BHC, pia huitwa "mwisho wa joto" - BHCs mara nyingi huendesha uingiliaji wao moja kwa moja katika chumba cha uchunguzi wa matibabu, kwa hivyo wagonjwa hawahitaji kubadilisha maeneo au kuhisi stigma iliyoongezeka kwa kutembelea BHC na kujadili wasiwasi wa afya ya tabia. Utaratibu wa utoaji wa huduma katika mfano wa huduma ya afya ya tabia iliyounganishwa pia inatofautiana na huduma ya jadi.