Mental health integrated care models in primary care settings and factors contributing to their effectiveness – a scoping review

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Abstract

Mental health services in the state of Victoria are fragmented and not fit for purpose thereby resulting in a large group of individuals with unmet mental health care needs. The Royal Commission recommended that collaboration and communication occur between services within and beyond the mental health system and that continuing research, evaluation and innovation be used to respond to community needs. General practitioners (GPs) serve as the gateways to the health service system in Australia and the most commonly discussed health problem with GPs relates to mental health. This review describes the models of integrated care within primary care settings similar to that of Australia that have been effective in improving mental health outcomes. It also outlines the factors that contributed to their effectiveness.

The key elements of effective mental health integrated care models relevant to the Australian primary care setting are:
Co-location in the primary care setting
Presence of a licensed mental health clinician (MHC)
Patient education
Collaborative practice
Ongoing monitoring
Integrated electronic medical records

The key factors that contribute to the effectiveness of such models that may be relevant to the Australian primary care setting are:

Development of sustainable funding mechanisms
Willingness to accept and promote system change
Presence of a care manager
Adequate training
Standardized workflow plan and care pathways
Consolidated physical and mental clinical records
Healthy organisational culture
Regular supervision and support

Services that have succeeded in implementing integrated care models have the rather unique characteristics of a positive organisational culture and vision. Lessons learned from the Mental Health Nurse Incentive Program model and the use of online and digital tools such as the Initial Assessment and Referral-Decision Support Tool used in the Head to Health model could inform integrated care models suitable for Australian primary care settings.
Original languageEnglish
PublisherMonash University
Commissioning bodyMelbourne Primary Care Network Limited (MPCN) (trading as North Western Melbourne Primary Health Network (NWMPHN))
Number of pages36
Publication statusPublished - 2023

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