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Book Effects of Care Models to Improve General Medical Outcomes for Individuals with Serious Mental Illness

Download or read book Effects of Care Models to Improve General Medical Outcomes for Individuals with Serious Mental Illness written by U. S. Department of Veterans Affairs and published by Createspace Independent Pub. This book was released on 2013-05-29 with total page 66 pages. Available in PDF, EPUB and Kindle. Book excerpt: Individuals with serious mental illness (SMI) have shortened life expectancies relative to the general population to an extent that is not explained by unnatural causes such as suicide or accidents. Epidemiological studies have estimated the life expectancy of individuals with schizophrenia to be 10 to 25 years less than the general population. Increased morbidity of both chronic and acute illnesses in individuals with SMI also reduces quality of life and increases the overall burden of disability beyond that of the SMI itself. SMIs have an overwhelming economic impact, as measured by direct and indirect costs, including health care costs, disability payments, lost productivity, and law enforcement costs. For example, one study estimated annual costs due to schizophrenia to be $62.7 billion annually in the U.S., and patients with bipolar disorder are estimated to have the highest total health care costs of any mental illness with up to 70 percent of these costs in non–mental health (e.g., primary care) settings. Given these issues, methods to improve general medical services for individuals with SMI is a pressing priority. The issues that influence general medical outcomes for individuals with SMI are complex and overlapping and likely vary by disease state. Relevant factors can be categorized to include population characteristics, contextual and system factors, provider factors, and community resources. Interventions aimed at improving general medical outcomes in this population could be directed at any one, or several, of these factors. The populations of individuals with SMI have consistently shown higher rates of illnesses, such as infectious disease, diabetes, respiratory illness, and cardiovascular disease, than the general population. Modifiable risk factors for poor health, such as smoking, obesity, alcohol and substance abuse, and lack of exercise, are highly prevalent in individuals with SMI—as are obstacles to optimal health care such as poverty, homelessness, and social isolation. Multiple studies show diminished guideline concordance of general medical care provided to individuals with SMI, as evidenced by reduced receipt of preventive medical services and lower quality of chronic disease management for illnesses such as diabetes and cardiovascular disease as well as acute illnesses such as myocardial infarction. In addition, psychiatric medications can be risk factors for poor health given the association with some pharmacological treatments and medical outcomes such as increased risk of sudden death, hyperglycemia, hyperlipidemia, and weight gain. We conducted a systematic review of the peer-reviewed literature to answer the following key questions (KQs): KQ 1. What types of care models have been evaluated prospectively that integrate mental health care and primary medical care with the goal of improving general medical outcomes for individuals with serious mental illness (SMI)? KQ 2. Do models of integrated care for individuals with SMI improve the process of care for preventive services (e.g., colorectal cancer screening) and chronic disease management (e.g., annual eye examination in patients with diabetes mellitus [DM])? KQ 3. (3a) Do models of integrated care for individuals with SMI improve general functional status outcomes (e.g., as measured by SF-36) or disease-specific functional status outcomes (e.g., Seattle Angina Questionnaire) related to medical care for chronic medical conditions such as DM, hypertension, or heart failure? (3b) Do models of integrated care for individuals with SMI improve clinical outcomes related to preventive services (e.g., influenza rates) and chronic medical care (e.g., kidney disease, amputations, retinopathy in patients with coexisting DM)? KQ 4. What are the gaps in evidence for determining how best to integrate care to improve general medical outcomes for individuals with SMI?

Book Effects of Care Models to Improve General Medical Outcomes for Individuals with Serious Mental Illness

Download or read book Effects of Care Models to Improve General Medical Outcomes for Individuals with Serious Mental Illness written by and published by . This book was released on 2011 with total page 60 pages. Available in PDF, EPUB and Kindle. Book excerpt: Individuals with serious mental illness (SMI) have shortened life expectancies relative to the general population to an extent that is not explained by unnatural causes such as suicide or accidents. Numerous studies show higher rates of acute and chronic illnesses, lower quality general medical care and worse outcomes in individuals with SMI. The issues that influence general medical outcomes for individuals with SMI are complex and overlapping and likely vary by disease state. Relevant factors can be categorized to include population characteristics, contextual and system factors, provider factors, and community resources. Interventions aimed at improving general medical outcomes in this population could be directed at any one, or several, of these factors. The organization of service delivery for individuals with SMI may be the most modifiable of the many factors that impact general medical outcomes in this population. In this review, we sought to evaluate models of care designed to improve general medical outcomes among individuals with SMI.

Book Improving the Quality of Health Care for Mental and Substance Use Conditions

Download or read book Improving the Quality of Health Care for Mental and Substance Use Conditions written by Institute of Medicine and published by National Academies Press. This book was released on 2006-03-29 with total page 528 pages. Available in PDF, EPUB and Kindle. Book excerpt: Each year, more than 33 million Americans receive health care for mental or substance-use conditions, or both. Together, mental and substance-use illnesses are the leading cause of death and disability for women, the highest for men ages 15-44, and the second highest for all men. Effective treatments exist, but services are frequently fragmented and, as with general health care, there are barriers that prevent many from receiving these treatments as designed or at all. The consequences of this are seriousâ€"for these individuals and their families; their employers and the workforce; for the nation's economy; as well as the education, welfare, and justice systems. Improving the Quality of Health Care for Mental and Substance-Use Conditions examines the distinctive characteristics of health care for mental and substance-use conditions, including payment, benefit coverage, and regulatory issues, as well as health care organization and delivery issues. This new volume in the Quality Chasm series puts forth an agenda for improving the quality of this care based on this analysis. Patients and their families, primary health care providers, specialty mental health and substance-use treatment providers, health care organizations, health plans, purchasers of group health care, and all involved in health care for mental and substanceâ€"use conditions will benefit from this guide to achieving better care.

Book Common Mental Health Disorders

Download or read book Common Mental Health Disorders written by National Collaborating Centre for Mental Health (Great Britain) and published by RCPsych Publications. This book was released on 2011 with total page 316 pages. Available in PDF, EPUB and Kindle. Book excerpt: Bringing together treatment and referral advice from existing guidelines, this text aims to improve access to services and recognition of common mental health disorders in adults and provide advice on the principles that need to be adopted to develop appropriate referral and local care pathways.

Book Crossing the Quality Chasm

    Book Details:
  • Author : Institute of Medicine
  • Publisher : National Academies Press
  • Release : 2001-07-19
  • ISBN : 0309132967
  • Pages : 359 pages

Download or read book Crossing the Quality Chasm written by Institute of Medicine and published by National Academies Press. This book was released on 2001-07-19 with total page 359 pages. Available in PDF, EPUB and Kindle. Book excerpt: Second in a series of publications from the Institute of Medicine's Quality of Health Care in America project Today's health care providers have more research findings and more technology available to them than ever before. Yet recent reports have raised serious doubts about the quality of health care in America. Crossing the Quality Chasm makes an urgent call for fundamental change to close the quality gap. This book recommends a sweeping redesign of the American health care system and provides overarching principles for specific direction for policymakers, health care leaders, clinicians, regulators, purchasers, and others. In this comprehensive volume the committee offers: A set of performance expectations for the 21st century health care system. A set of 10 new rules to guide patient-clinician relationships. A suggested organizing framework to better align the incentives inherent in payment and accountability with improvements in quality. Key steps to promote evidence-based practice and strengthen clinical information systems. Analyzing health care organizations as complex systems, Crossing the Quality Chasm also documents the causes of the quality gap, identifies current practices that impede quality care, and explores how systems approaches can be used to implement change.

Book Care Without Coverage

    Book Details:
  • Author : Institute of Medicine
  • Publisher : National Academies Press
  • Release : 2002-06-20
  • ISBN : 0309083435
  • Pages : 213 pages

Download or read book Care Without Coverage written by Institute of Medicine and published by National Academies Press. This book was released on 2002-06-20 with total page 213 pages. Available in PDF, EPUB and Kindle. Book excerpt: Many Americans believe that people who lack health insurance somehow get the care they really need. Care Without Coverage examines the real consequences for adults who lack health insurance. The study presents findings in the areas of prevention and screening, cancer, chronic illness, hospital-based care, and general health status. The committee looked at the consequences of being uninsured for people suffering from cancer, diabetes, HIV infection and AIDS, heart and kidney disease, mental illness, traumatic injuries, and heart attacks. It focused on the roughly 30 million-one in seven-working-age Americans without health insurance. This group does not include the population over 65 that is covered by Medicare or the nearly 10 million children who are uninsured in this country. The main findings of the report are that working-age Americans without health insurance are more likely to receive too little medical care and receive it too late; be sicker and die sooner; and receive poorer care when they are in the hospital, even for acute situations like a motor vehicle crash.

Book Primary Care

    Book Details:
  • Author : Institute of Medicine
  • Publisher : National Academies Press
  • Release : 1996-09-05
  • ISBN : 0309175690
  • Pages : 411 pages

Download or read book Primary Care written by Institute of Medicine and published by National Academies Press. This book was released on 1996-09-05 with total page 411 pages. Available in PDF, EPUB and Kindle. Book excerpt: 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.

Book The Social Determinants of Mental Health

Download or read book The Social Determinants of Mental Health written by Michael T. Compton and published by American Psychiatric Pub. This book was released on 2015-04-01 with total page 296 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Social Determinants of Mental Health aims to fill the gap that exists in the psychiatric, scholarly, and policy-related literature on the social determinants of mental health: those factors stemming from where we learn, play, live, work, and age that impact our overall mental health and well-being. The editors and an impressive roster of chapter authors from diverse scholarly backgrounds provide detailed information on topics such as discrimination and social exclusion; adverse early life experiences; poor education; unemployment, underemployment, and job insecurity; income inequality, poverty, and neighborhood deprivation; food insecurity; poor housing quality and housing instability; adverse features of the built environment; and poor access to mental health care. This thought-provoking book offers many beneficial features for clinicians and public health professionals: Clinical vignettes are included, designed to make the content accessible to readers who are primarily clinicians and also to demonstrate the practical, individual-level applicability of the subject matter for those who typically work at the public health, population, and/or policy level. Policy implications are discussed throughout, designed to make the content accessible to readers who work primarily at the public health or population level and also to demonstrate the policy relevance of the subject matter for those who typically work at the clinical level. All chapters include five to six key points that focus on the most important content, helping to both prepare the reader with a brief overview of the chapter's main points and reinforce the "take-away" messages afterward. In addition to the main body of the book, which focuses on selected individual social determinants of mental health, the volume includes an in-depth overview that summarizes the editors' and their colleagues' conceptualization, as well as a final chapter coauthored by Dr. David Satcher, 16th Surgeon General of the United States, that serves as a "Call to Action," offering specific actions that can be taken by both clinicians and policymakers to address the social determinants of mental health. The editors have succeeded in the difficult task of balancing the individual/clinical/patient perspective and the population/public health/community point of view, while underscoring the need for both groups to work in a unified way to address the inequities in twenty-first century America. The Social Determinants of Mental Health gives readers the tools to understand and act to improve mental health and reduce risk for mental illnesses for individuals and communities. Students preparing for the Medical College Admission Test (MCAT) will also benefit from this book, as the MCAT in 2015 will test applicants' knowledge of social determinants of health. The social determinants of mental health are not distinct from the social determinants of physical health, although they deserve special emphasis given the prevalence and burden of poor mental health.

Book Evidence Based Practices in Mental Health Care

Download or read book Evidence Based Practices in Mental Health Care written by American Psychiatric Association and published by American Psychiatric Pub. This book was released on 2008-05-20 with total page 124 pages. Available in PDF, EPUB and Kindle. Book excerpt: As the first attempt to synthesize the movement toward widespread implementation of evidence-based mental health practices, this groundbreaking collection articulates the basic tenets of evidence-based medicine and shows how practices proven effective by clinical services research could improve the lives of many people. Intended to stimulate much-needed public discussion, these remarkable contributions cover both general issues, such as Implementing practices in routine mental health settings, including strategies for disseminating evidence-based practices to staff members Ensuring that efforts to implement such practices are informed by the knowledge and experience of administrators, clinicians, patients, and advocates Integrating evidence-based practices with the recovery model and focusing on guidelines and algorithms for pharmacologic treatment of people with severe mental illness Identifying the policy implications of the movement, particularly in public-sector settings, and describing eight courses of action for addressing the gap between science and practice and specific practices, such as Describing critical components of practices for which substantial evidence exists, such as supported employment, dual diagnosis services, and assertive community treatment Developing an evidence base for particular populations, such as children and adolescents and geriatric patients; and for clinical subgroups, such as patients with severe mental illness and posttraumatic stress disorder-and implementing a range of practices for each population Debate in public forums is critical to explaining the benefits of evidence-based care and allaying the fears of patients, practitioners, administrators, policy makers, and vested interest groups that evidence-based care excludes them from the decision-making process. Patients need to know that their individual characteristics, preferences, and autonomy are highly valued and won't be discounted by rigid adherence to the particular treatments. Practitioners need to know about the credibility of the evidence base and about new techniques and responsibilities and to understand that their favorite practices won't necessarily be excluded during initial attempts to implement evidence-based practices. Administrators and policy makers need to know about financing, organizing, implementing, and sustaining new practices. Finally, vested interest groups need to know that the introduction of evidence-based practices doesn't mean that what they do now is ineffective. This unique and densely informative volume will be welcomed by mental health care professionals and by lawmakers, planners, administrators, and others who are charged with the responsibility of providing effective care to vulnerable populations.

Book Caring for People with Severe Mental Disorders

Download or read book Caring for People with Severe Mental Disorders written by United States. National Advisory Mental Health Council and published by . This book was released on 1991 with total page 96 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Book Managing Managed Care

    Book Details:
  • Author : Institute of Medicine
  • Publisher : National Academies Press
  • Release : 1997-04-21
  • ISBN : 0309175054
  • Pages : 394 pages

Download or read book Managing Managed Care written by Institute of Medicine and published by National Academies Press. This book was released on 1997-04-21 with total page 394 pages. Available in PDF, EPUB and Kindle. Book excerpt: Managed care has produced dramatic changes in the treatment of mental health and substance abuse problems, known as behavioral health. Managing Managed Care offers an urgently needed assessment of managed care for behavioral health and a framework for purchasing, delivering, and ensuring the quality of behavioral health care. It presents the first objective analysis of the powerful multimillion-dollar accreditation industry and the key accrediting organizations. Managing Managed Care draws evidence-based conclusions about the effectiveness of behavioral health treatments and makes recommendations that address consumer protections, quality improvements, structure and financing, roles of public and private participants, inclusion of special populations, and ethical issues. The volume discusses trends in managed behavioral health care, highlighting the emerging role of the purchaser. The committee explores problems of overlap and fragmentation in the delivery of behavioral health care and discusses the issue of access, a special concern when private systems are restricted and public systems overburdened. Highly applicable to the larger health care system, this volume will be of particular interest to all stakeholders in behavioral healthâ€"federal and state policymakers, public and private purchasers, health care providers and administrators, consumers and consumer advocates, accrediting organizations, and health services researchers.

Book Complementary and Alternative Treatments in Mental Health Care

Download or read book Complementary and Alternative Treatments in Mental Health Care written by James H. Lake and published by American Psychiatric Pub. This book was released on 2007-04-02 with total page 508 pages. Available in PDF, EPUB and Kindle. Book excerpt: The widespread use of nonconventional treatments, or complementary and alternative medicine (CAM), and the increasing evidence supporting their therapeutic benefits call for a concerted scientific effort to integrate treatments that work into mainstream medicines. Answering that call is the groundbreaking Complementary and Alternative Treatments in Mental Health Care, a concise, practical reference that reviews the many CAM approaches used in North America and Europe to treat -- or self-treat -- mental health problems, and the history and rationale for a variety of CAM treatments, including the risks and benefits of their integration into mainstream mental health care. Two dozen contributors with both conventional and nonconventional expertise present current information about safe, effective mental health treatments -- including herbals and other natural products, stress management, homeopathy, Ayurveda, and traditional Chinese medicine -- that have not yet been fully examined or endorsed by the institutions of conventional biomedicine. This book: Covers background issues, including conceptual and historical foundations, emerging ideas and trends, safety issues, potential drug interactions and adverse effects, and medical-legal issues pertaining to use of nonconventional treatments in mental health care. Reviews the evidence and offers practical clinical guidelines for the most widely used nonconventional treatments. Twelve chapters cover specific nonconventional modalities or alternative professional systems of medicine currently used to treat mental illness, addressing historical uses of the specified modality, significant recent research findings, unresolved safety issues, and evidence supporting use of the specified approach in common psychiatric disorders, from major depressive and bipolar disorder, schizophrenia, and generalized anxiety disorder to obsessive-compulsive disorder, dementia, and sleep and substance abuse disorders. Practical clinical applications of complementary and alternative approaches are discussed throughout the book. Closes with three appendixes and a subject and author index. Appendix A ranks evidence for the various treatment modalities by major psychiatric disorder and is cross-referenced with the material in Part II. Appendix B lists important Web sites, textbooks, professional associations, and other resources. Appendix C contains a glossary of key terms used in complementary and alternative medicine. Written for both conventionally and nonconventionally trained mental health care professionals, Complementary and Alternative Treatments in Mental Health Care provides both an ideal reference for clinicians whose patients inquire about the uses of many CAM therapies and a critical, balanced review of the nonconventional modalities most widely used in Western countries to treat mental or emotional problems.

Book Mental Health

Download or read book Mental Health written by and published by . This book was released on 2001 with total page 28 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Book Depression and Diabetes

    Book Details:
  • Author : Wayne Katon
  • Publisher : John Wiley & Sons
  • Release : 2011-06-09
  • ISBN : 1119957478
  • Pages : 197 pages

Download or read book Depression and Diabetes written by Wayne Katon and published by John Wiley & Sons. This book was released on 2011-06-09 with total page 197 pages. Available in PDF, EPUB and Kindle. Book excerpt: In recent years, there has been a growing awareness of the multiple interrelationships between depression and various physical diseases. The WPA is providing an update of currently available evidence on these interrelationships by the publication of three books, dealing with the comorbidity of depression with diabetes, heart disease and cancer. Depression is a frequent and serious comorbid condition in diabetes, which adversely affects quality of life and the long-term prognosis. Co-occurrent depression presents peculiar clinical challenges, making both conditions harder to manage. Depression and Diabetes is the first book devoted to the interaction between these common disorders. World leaders in diabetes, depression and public health synthesize current evidence, including some previously unpublished data, in a concise, easy-to-read format. They provide an overview of the epidemiology, pathogenesis, medical costs, management, and public health and cultural implications of the comorbidity between depression and diabetes. The book describes how the negative consequences of depression in diabetes could be avoided, given that effective depression treatments for diabetic patients are available. Its practical approach makes the book ideal for all those involved in the management of these patients: psychiatrists, psychologists, diabetologists, general practitioners, diabetes specialist nurses and mental health nurses.

Book New Models of Care for Patients with Severe Mental Illness     Bridging In  and Outpatients

Download or read book New Models of Care for Patients with Severe Mental Illness Bridging In and Outpatients written by Martin Heinze and published by Frontiers Media SA. This book was released on 2018-03-13 with total page 94 pages. Available in PDF, EPUB and Kindle. Book excerpt: Over the past years, psychiatric services have been continuously faced with the challenge of providing comprehensive care to people suffering from severe mental illnesses. Legal and conceptual advances like the UN convention on the rights of persons with disabilities or the concept of recovery have rendered this challenge more actual and urgent than ever. However, psychiatric institutions often show only low levels of cooperation and integration between their different services. Hence, they need to develop new ways of bridging all sectors of care in order to help people most in need on their way to recovery and full inclusion in society. In this research topic, European researchers and clinicians present new ways of dealing with this essential issue by developing strategies and interventions on both institutional and non-institutional levels. The nine contributions of this ebook thus reflect actual clinical and conceptual considerations. They all aim at improving quality of care and providing adequate support to people suffering from severe mental illness.

Book Schizophrenia and Public Health

Download or read book Schizophrenia and Public Health written by Angelo Barbato and published by . This book was released on 1996 with total page 32 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Book Psychosis and Schizophrenia in Children and Young People

Download or read book Psychosis and Schizophrenia in Children and Young People written by National Collaborating Centre for Mental Health (Great Britain) and published by RCPsych Publications. This book was released on 2013 with total page 512 pages. Available in PDF, EPUB and Kindle. Book excerpt: These guidelines from NICE set out clear recommendations, based on the best available evidence, for health care professionals on how to work with and implement physical, psychological and service-level interventions for people with various mental health conditions.The book contains the full guidelines that cannot be obtained in print anywhere else. It brings together all of the evidence that led to the recommendations made, detailed explanations of the methodology behind their preparation, plus an overview of the condition covering detection, diagnosis and assessment, and the full range of treatment and care approaches. There is a worse prognosis for psychosis and schizophrenia when onset is in childhood or adolescence, and this new NICE guideline puts much-needed emphasis on early recognition and assessment of possible psychotic symptoms. For the one-third of children and young people who go on to experience severe impairment as a result of psychosis or schizophrenia the guideline also offers comprehensive advice from assessment and treatment of the first episode through to promoting recovery.This guideline reviews the evidence for recognition and management of psychosis and schizophrenia in children and young people across the care pathway, encompassing access to and delivery of services, experience of care, recognition and management of at-risk mental states, psychological and pharmacological interventions, and improving cognition and enhancing engagement with education and employment.