Mental Health Case Study

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5.2.1 Integrating Mental Health into Primary Care for Mild-to-Moderate Disorders

The term “mild-to-moderate” is described as set of mental disorders such as depression and a range of anxiety disorders, panic disorders, phobias, somatoform disorders, eating disorders and ADHDs (Attention Deficit and Hyperactivity Disorders)(OECD 2014) . Mild-to-moderate disorders are estimated to have high prevalence rate in OECD populations.

Research studies, evaluating treatment models, have shed consistent evidence that treating common mental disorders (such as depression or anxiety) in primary care settings is more effective approach compared to the prevailing mode of delivering treatment through specialist facilities in psychiatric hospitals. It
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‘Collaborative’ or integrated care models restructure the roles of health care providers, introduce a team-based approach, in which general physicians (GPs) provide a prime link in the entire chain of delivering mental health services. GPs are the first point of contact for all people in most countries. For example, OECD 2011(Health at a Glance – OECD Indicators) reported that for selected EU countries, the General Practitioner (GPs) was overwhelmingly more likely to be consulted for mental health problems than psychiatrists or psychologists. In the US, approximately 20 to 25% of primary care patients have one or more psychiatric disorders—most commonly anxiety, depressive, and alcohol/substance abuse disorders (Katon & Unutzer, 2013). Despite the prime role of GPs as a health care provider, the prevailing practice in most countries requires GPs to …show more content…
. The authors found that the supplementation of usual care with a nurse-delivered complex intervention improved the symptoms of depression more than did usual care alone. The study also noted that this complex intervention was cost effective- It cost an additional (incremental cost) £5278 (US$10 556) per quality-adjusted life-year gained (compared with a median cost per quality-adjusted life-year of at least £10 000 ($20 000) for anticancer treatments.). Sharpe et al., (2014) have suggested on enhancing treatment of depression in cancer patients using a collaborative practice model—in the SMaRT Oncology-2 Trial.

Given the multifaceted nature of the co-morbidity, both physiologically and psychosocially, the NHS (2010) report on collaborative care suggests that a significant number of people will require complex interventions, such as collaborative care, to deliver improvements in both their mental and physical health (Bhardwaj, A

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