Ask for a definition of primary care, and you are likely to hear as many answers as there are health care professionals in your survey. Primary Care fills this gap with a detailed definition already adopted by professional organizations and praised at recent conferences. This volume makes recommendations for improving primary care, building its organization, financing, infrastructure, and knowledge baseâ€"as well as developing a way of thinking and acting for primary care clinicians. Are there enough primary care doctors? Are they merely gatekeepers? Is the traditional relationship between patient and doctor outmoded? The committee draws conclusions about these and other controversies in a comprehensive and up-to-date discussion that covers: The scope of primary care. Its philosophical underpinnings. Its value to the patient and the community. Its impact on cost, access, and quality. This volume discusses the needs of special populations, the role of the capitation method of payment, and more. Recommendations are offered for achieving a more multidisciplinary education for primary care clinicians. Research priorities are identified. Primary Care provides a forward-thinking view of primary care as it should be practiced in the new integrated health care delivery systemsâ€"important to health care clinicians and those who train and employ them, policymakers at all levels, health care managers, payers, and interested individuals.

The purpose of this book is to provide a children’s mental health resource tailored to the needs of physicians working with children. There are currently no such texts, despite the fact that there are patient care, healthcare systems, and workforce factors that indicate a strong need for such a resource. Approximately 1 in 5 children are diagnosed with a mental illness by the age of 18. Additionally, mental health conditions, including Attention Deficit Hyperactivity Disorder, are consistently among the most common chronic conditions in pediatric clinical populations. Delays in both diagnosis and treatment increase the morbidity associated with these conditions. These delays expose the child to negative ramifications of his/her illness and can impact rates of poor academic performance, substance use disorders and criminal justice system involvement – potentially impacting long-term life trajectories. Early identification of mental illness and appropriate intervention is critical to the healthy development of youth, though physicians in primary care and pediatrics are seldom trained to detect and treat such illnesses. The importance of recognizing mental illness is reflected in practice guidelines for pediatric primary care providers as well as in how service delivery is being structured, but this does not offer in-depth clinical guidelines. Additionally, integrated care and medical home models include mental health as key components, though yet again physicians are often not trained to work with these models. While clearly indicated clinically, these requirements do not come with significant increases in reimbursement and are added to an already demanding schedule. Increasingly, providers are also expected to use evidence based screening instruments without exposure to this body of literature. Some guidance on using those instruments in context will help them to use those tools more effectively. Finally, primary care providers and even some adult psychiatrists and psychologists are operating in a healthcare system with a severe, nationwide shortage of child and adolescent psychiatrists and mental healthcare providers. While a text certainly cannot single-handedly compensate for such a workforce shortage, it could potentially help to mitigate the negative impact on patients by facilitating early identification and treatment in the primary care setting. Additionally, with more effective treatment in pediatric settings, less complex cases may be addressed before specialty care is needed, and the expertise of child and adolescent psychiatrists can be more effectively used for more complex cases. Pediatric Psychiatry in Primary Care is the ultimate resource for clinicians working with children, including pediatricians, family physicians, general psychiatrists, psychologists, early career child psychiatrists, social workers, nurses, school counselors, and all clinical professionals who may encounter children struggling with psychiatric disorders.

"This indispensable resource provides vital guidance for integrating mental health care into your primary care practice. Learn from leading experts the latest information on enhancements to the medical home and on the care of children and adolescents with mental health symptoms that do not rise to the threshold for a diagnosis, as well as those that do"--Publisher's description.

An innovative psychiatry textbook that presents behavioral disorders from the perspective of what is seen in medical settings The goal of Essentials of Psychiatry in Primary Care is not to make psychiatrists out of medical clinicians, but rather, to help clinicians manage common behavioral conditions that most often present in a medical setting. Essentials of Psychiatry in Primary Care seeks to integrate medicine and psychiatry --- as the authors’ systems-based biopsychosocial model proposes. The book identifies physical symptoms as a common mode of presentation of mental health problems and describes how to integrate them with psychological symptoms to make diagnoses of mental disorders. Essentials of Psychiatry in Primary Care also details a behaviorally defined, evidence-based mental healthcare model that can be effectively used in a medical setting. The combined experiences in primary care of the authors --- who specialize in both general internal medicine and psychiatry --- provide the perfect background for a book of this nature. Having trained medical students, as well as internal and family medicine residents since 1986, their experience and research demonstrates the information they outline is effective and associated with improved mental and physical health outcomes.

Comprehensive, wise, and incredibly practical, this exciting volume walks through the joys and challenges of an entirely new vision of behavioral health consultation in primary care settings. Gently, and with good humor, the authors show how to avoid key errors, and provide a detailed, point by point guideline for success in an effective and needed new form of practice. You will forever think differently about the proper role of behavioral health providers in health care delivery. Even better, you will be prepared to do something about it. -- Steven C. Hayes, University of Nevada The Primary Care Behavioral Health (PCBH) model is fast emerging as the future of integration between mental health and primary care services. As the first book to detail the model, Behavioral Consultation and Primary Care: A Guide to Integrating Services explains in hands-on terms how to achieve truly integrated care. From starting up a new PCBH service to evaluating its outcome, clinicians and medical administrators alike will find much of value here. Written by two veteran Behavioral Health Consultants (BHCs), the Guide offers a wealth of practical advice for all levels of therapists entering primary care. Every detail of BHC work is discussed, ranging from key job competencies to proven strategies for navigating challenging new terrain. Detailed case examples also bring theory to life for a wide variety of common clinical problems. Real-world features designed to help establish a service and ease the transition from specialty mental health to primary care: -Specific administrative recommendations for setting up a BHC office, scheduling patients, billing, and staffing -Start-up checklist, chart note templates, handouts for generating referrals, and other valuable tools -Chapters outlining the therapeutic approaches and assessment methods best suited to BHC work -Creative strategies for influencing that new colleague--the primary care provider-Case examples to illustrate typical consultations with children, adults, and older adults, as well as innovative group approaches -Tips for handling ethical concerns unique to the PCBH model, and professional and personal challenges unique to the primary care setting The authors’ lively and engaging style is accessible to a wide range of professionals, so seasoned practitioners and neophytes--as well as the administrators who hire them--will find this material totally accessible. In addition to assisting professionals in the field, the Guide is perfectly suited for use in a variety of graduate classes and residency training programs.

An invaluable guide to psychiatric presentation, diagnosis and treatment in a primary care setting.

Interpersonal trauma is ubiquitous and its impact on health has long been understood. Recently, however, the critical importance of this issue has been magnified in the public eye. A burgeoning literature has demonstrated the impact of traumatic experiences on mental and physical health, and many potential interventions have been proposed. This volume serves as a detailed, practical guide to trauma-informed care. Chapters provide guidance to both healthcare providers and organizations on strategies for adopting, implementing and sustaining principles of trauma-informed care. The first section maps out the scope of the problem and defines specific types of interpersonal trauma. The authors then turn to discussion of adaptations to care for special populations, including sexual and gender minority persons, immigrants, male survivors and Veterans as these groups often require more nuanced approaches. Caring for trauma-exposed patients can place a strain on clinicians, and approaches for fostering resilience and promoting wellness among staff are presented next. Finally, the book covers concrete trauma-informed clinical strategies in adult and pediatric primary care, and women’s health/maternity care settings. Using a case-based approach, the expert authors provide real-world front line examples of the impact trauma-informed clinical approaches have on patients’ quality of life, sense of comfort, and trust. Case examples are discussed along with evidence based approaches that demonstrate improved health outcomes. Written by experts in the field, Trauma-Informed Healthcare Approaches is the definitive resource for improving quality care for patients who have experienced trauma.