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Primary Care Behavioral health
Primary Care Behavioral Health Consultation model (PCBH) is a psychological approach to population-based clinical health care that is simultaneously co-located, collaborative, and integrated within the primary care clinic. The goal of PCBH is to improve and promote overall health within the general population. This approach is important because approximately half of all patients in primary care present with psychiatric comorbidities, and 60% of psychiatric illness is treated in primary care. Primary Care practice has traditionally adopted a generalist approach whereby physicians are trained in the medical model and solutions to problems typically involve medications, procedures, and advice. Appointment times are short, with the goal of seeing a large number of patients in a day. Many patients present with mental health care needs whose symptomology may overlap with medical disorders and which may exacerbate, complicate, or masquerade as physical symptoms. In addition, many medical problems present with associated psychological sequelae (e.g. stress, emotional reactions, dysfunctional lifestyle behaviors), that are amenable to change, through behavioral intervention, that can improve outcomes for these health problems. Over 50% of medical visits to primary care clinics today are related to chronic medical conditions (e.g. chronic pain, diabetes, COPD, hypertension, obesity). As we learn more and more about the contributing factors to the development and maintenance of these medical problems, there is growing evidence that the PCBH model affords us the opportunity for early identification and behavioral/medical intervention that can prevent some acute problems from becoming chronic health care problems. Behavioral Health Consultants (BHCs) work side-by-side with all members of the clinical care team (including primary care providers (PCPs) and nursing staff) to enhance preventive and clinical care for mental health problems that have traditionally been treated solely by physicians. The role of the BHC is to facilitate systemic change within primary care that facilitates a multidisciplinary approach both from a treatment and reimbursement standpoint. BHCs typically collaborate with physicians to develop treatment plans, monitor patient progress, and flexibly provide care to meet patients’ changing needs〔Robinson, P.J. and Reiter, J.T. (2007). Behavioral Consultation and Primary Care (pp 1-16). N.Y.: Springer Science + Business Media.〕 In this review the terms Primary Care Behavioral Health Consultation and Behavioral Health Consultation will be used interchangeably.
== Associated Terms ==
Primary Care Psychology: Provision of clinical mental health services through a population-based focus on the common problems confronting a majority of individuals. Such issues treated in primary care may include response to physical illness, stress, affective concerns, substance use and abuse, and developmental and situational issues among others. Primary care psychologists are co-located with primary care providers and usually share the same physical space in practice. Primary care psychologists may retain the traditional session length of specialty care or may adhere to a brief, consultative approach that is solution-focused. Primary Care Psychologists may often be trained in health psychology programs, but not exclusively so.
Behavioral Health Consultant: Behavioral Health Consultants and Primary Care Physicians collaborate within the same system. The behavioral health provider works as part of the medical team to meet the wide range of needs with which patients present.〔Hunter, C.L., Goodie, J.L., Oordt, M.S., & Dobmeyer A.C., (2009), Integrated behavioral health in primary care: Step-by-step guidance for assessment and intervention. Washington, DC: American Psychological Association.〕
Collaborative Care: This model uses databases or what are known as registries to track and monitor patients with certain conditions. Typical examples in primary care include diabetes and depression. Often the person managing the registry is a nurse or mental health professional who performs follow-up phone calls and assists the primary care team in following evidence-based protocols. There is often also a consulting psychiatrist who oversees the provision of care in primary care.
抄文引用元・出典: フリー百科事典『 ウィキペディア（Wikipedia）』
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