OBJECTIVE: To facilitate planning to improve care delivery in community health clinics, this study provides an in-depth description of the social, cultural, and organizational factors that create the context for mental health and addictions treatment delivery in this setting. METHODS: Seventeen community health clinic providers and personnel were interviewed for 45-90 minutes with open-ended questions to elicit the context of their frontline provider experiences. Major themes and subthemes of responses were identified with content analysis. RESULTS: Issues that create significant barriers to care included complex patient comorbidity and demographic characteristics; clinic organization, resources, and funding shortfalls; communication barriers with specialty mental health and addictions agencies; and stigmatizing aspects of mental health, addictions, and disadvantaged status. CONCLUSIONS: The unique barriers to care in the community health care setting, as well as the unique characteristics of patients served, are likely to require context-specific solutions. These solutions will determine the viability of existing chronic disease management models, such as collaborative care, when applied to this setting.
OBJECTIVE: To facilitate planning to improve care delivery in community health clinics, this study provides an in-depth description of the social, cultural, and organizational factors that create the context for mental health and addictions treatment delivery in this setting. METHODS: Seventeen community health clinic providers and personnel were interviewed for 45-90 minutes with open-ended questions to elicit the context of their frontline provider experiences. Major themes and subthemes of responses were identified with content analysis. RESULTS: Issues that create significant barriers to care included complex patient comorbidity and demographic characteristics; clinic organization, resources, and funding shortfalls; communication barriers with specialty mental health and addictions agencies; and stigmatizing aspects of mental health, addictions, and disadvantaged status. CONCLUSIONS: The unique barriers to care in the community health care setting, as well as the unique characteristics of patients served, are likely to require context-specific solutions. These solutions will determine the viability of existing chronic disease management models, such as collaborative care, when applied to this setting.
Authors: Joyce Y Chung; Lori Frank; Asha Subramanian; Steve Galen; Sarah Leonhard; Bonnie L Green Journal: J Nerv Ment Dis Date: 2012-05 Impact factor: 2.254
Authors: Laura-Louise Arundell; Helen Greenwood; Helen Baldwin; Eleanor Kotas; Shubulade Smith; Kasia Trojanowska; Chris Cooper Journal: Syst Rev Date: 2020-05-26