Interdisciplinary Team Perspectives on Mental Health Care in VA Home-Based Primary Care: A Qualitative Study
•What is the primary question addressed by this study?This qualitative study sought to examine the question: What are the attributes and gaps in mental health services for Veterans in the U.S. Department of Veteran's Affairs (VA) Home-Based Primary Care Program (HBPC)?•What is the main finding...
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| Veröffentlicht in: | The American journal of geriatric psychiatry 2019-02, Vol.27 (2), p.128-137 |
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| container_title | The American journal of geriatric psychiatry |
| container_volume | 27 |
| creator | Gillespie, Suzanne M. Manheim, Chelsea Gilman, Carrie Karuza, Jurgis Olsan, Tobie H. Edwards, Samuel T. Levy, Cari R. Haverhals, Leah |
| description | •What is the primary question addressed by this study?This qualitative study sought to examine the question: What are the attributes and gaps in mental health services for Veterans in the U.S. Department of Veteran's Affairs (VA) Home-Based Primary Care Program (HBPC)?•What is the main finding of this study?The study identifies four themes related to the provision of mental health care in HBPC: 1) HBPC Veterans have not only complex physical needs but also co-occurring mental needs; 2) the multi-faceted role of psychologists on HBPC teams that includes providing care for Veterans and support for colleagues; 3) collaboration between medical and mental health providers as a means of caring for HBPC Veterans with mental health needs; and 4) gaps in providing mental health care on HBPC teams, primarily related to a lack of team psychiatrists and/or need for specialized medication management for psychiatric illness.•What is the meaning of the finding?Mental health providers are an essential component of HBPC teams. Improved understanding of HBPC mental health provider models will be valuable to optimizing care of homebound adults.
This qualitative study describes the structure and processes of providing care to U.S. Department of Veterans Affairs (VA) Home-Based Primary Care (HBPC) enrollees with mental health care needs; explains the role of the HBPC psychologist; and describes how mental health treatment is integrated into care from the perspective of HBPC team members.
HBPC programs were selected for in-person site visits based on initial surveys and low hospitalization rates.
Programs varied in setting, geographic locations, and primary care model.
Eight site visits were completed. During visits, key informants including HBPC program directors, medical directors, team members, and other key staff involved with the HBPC program participated in semi-structured individual and group interviews.
Recorded interviews, focus groups, and field observation notes.
Qualitative thematic content analysis revealed four themes: 1) HBPC Veterans have not only complex physical needs but also co-occurring mental health needs; 2) the multi-faceted role of psychologists on HBPC teams, that includes providing care for Veterans and support for colleagues; 3) collaboration between medical and mental health providers as a means of caring for HBPC Veterans with mental health needs; and 4) gaps in providing mental health care on HBPC teams, primarily related to a lack of team psychia |
| doi_str_mv | 10.1016/j.jagp.2018.10.006 |
| format | Article |
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This qualitative study describes the structure and processes of providing care to U.S. Department of Veterans Affairs (VA) Home-Based Primary Care (HBPC) enrollees with mental health care needs; explains the role of the HBPC psychologist; and describes how mental health treatment is integrated into care from the perspective of HBPC team members.
HBPC programs were selected for in-person site visits based on initial surveys and low hospitalization rates.
Programs varied in setting, geographic locations, and primary care model.
Eight site visits were completed. During visits, key informants including HBPC program directors, medical directors, team members, and other key staff involved with the HBPC program participated in semi-structured individual and group interviews.
Recorded interviews, focus groups, and field observation notes.
Qualitative thematic content analysis revealed four themes: 1) HBPC Veterans have not only complex physical needs but also co-occurring mental health needs; 2) the multi-faceted role of psychologists on HBPC teams, that includes providing care for Veterans and support for colleagues; 3) collaboration between medical and mental health providers as a means of caring for HBPC Veterans with mental health needs; and 4) gaps in providing mental health care on HBPC teams, primarily related to a lack of team psychiatrists and/or need for specialized medication management for psychiatric illness.
Mental health providers are essential to HBPC teams. Given the significant mental health care needs of HBPC enrollees and the roles of HBPC mental health providers, HBPC teams should integrate both psychologists and consulting psychiatrists.</description><identifier>ISSN: 1064-7481</identifier><identifier>EISSN: 1545-7214</identifier><identifier>DOI: 10.1016/j.jagp.2018.10.006</identifier><identifier>PMID: 30424995</identifier><language>eng</language><publisher>England: Elsevier Inc</publisher><subject>Aged ; Geriatric psychology ; Home Care Services - organization & administration ; Home-based primary care ; Hospitalization ; Humans ; Male ; mental health ; Mental health care ; Mental Health Services - organization & administration ; Patient Care Team - organization & administration ; Primary care ; Primary Health Care - organization & administration ; Qualitative Research ; United States ; United States Department of Veterans Affairs ; Veterans ; Veterans Health Services - organization & administration</subject><ispartof>The American journal of geriatric psychiatry, 2019-02, Vol.27 (2), p.128-137</ispartof><rights>2018</rights><rights>Copyright © 2018. Published by Elsevier Inc.</rights><rights>Copyright Elsevier Limited Feb 2019</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c384t-96806881cd6671ce618b684d059089f08745937ee362a11ea6dec011c0bfc9df3</citedby><cites>FETCH-LOGICAL-c384t-96806881cd6671ce618b684d059089f08745937ee362a11ea6dec011c0bfc9df3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30424995$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Gillespie, Suzanne M.</creatorcontrib><creatorcontrib>Manheim, Chelsea</creatorcontrib><creatorcontrib>Gilman, Carrie</creatorcontrib><creatorcontrib>Karuza, Jurgis</creatorcontrib><creatorcontrib>Olsan, Tobie H.</creatorcontrib><creatorcontrib>Edwards, Samuel T.</creatorcontrib><creatorcontrib>Levy, Cari R.</creatorcontrib><creatorcontrib>Haverhals, Leah</creatorcontrib><title>Interdisciplinary Team Perspectives on Mental Health Care in VA Home-Based Primary Care: A Qualitative Study</title><title>The American journal of geriatric psychiatry</title><addtitle>Am J Geriatr Psychiatry</addtitle><description>•What is the primary question addressed by this study?This qualitative study sought to examine the question: What are the attributes and gaps in mental health services for Veterans in the U.S. Department of Veteran's Affairs (VA) Home-Based Primary Care Program (HBPC)?•What is the main finding of this study?The study identifies four themes related to the provision of mental health care in HBPC: 1) HBPC Veterans have not only complex physical needs but also co-occurring mental needs; 2) the multi-faceted role of psychologists on HBPC teams that includes providing care for Veterans and support for colleagues; 3) collaboration between medical and mental health providers as a means of caring for HBPC Veterans with mental health needs; and 4) gaps in providing mental health care on HBPC teams, primarily related to a lack of team psychiatrists and/or need for specialized medication management for psychiatric illness.•What is the meaning of the finding?Mental health providers are an essential component of HBPC teams. Improved understanding of HBPC mental health provider models will be valuable to optimizing care of homebound adults.
This qualitative study describes the structure and processes of providing care to U.S. Department of Veterans Affairs (VA) Home-Based Primary Care (HBPC) enrollees with mental health care needs; explains the role of the HBPC psychologist; and describes how mental health treatment is integrated into care from the perspective of HBPC team members.
HBPC programs were selected for in-person site visits based on initial surveys and low hospitalization rates.
Programs varied in setting, geographic locations, and primary care model.
Eight site visits were completed. During visits, key informants including HBPC program directors, medical directors, team members, and other key staff involved with the HBPC program participated in semi-structured individual and group interviews.
Recorded interviews, focus groups, and field observation notes.
Qualitative thematic content analysis revealed four themes: 1) HBPC Veterans have not only complex physical needs but also co-occurring mental health needs; 2) the multi-faceted role of psychologists on HBPC teams, that includes providing care for Veterans and support for colleagues; 3) collaboration between medical and mental health providers as a means of caring for HBPC Veterans with mental health needs; and 4) gaps in providing mental health care on HBPC teams, primarily related to a lack of team psychiatrists and/or need for specialized medication management for psychiatric illness.
Mental health providers are essential to HBPC teams. Given the significant mental health care needs of HBPC enrollees and the roles of HBPC mental health providers, HBPC teams should integrate both psychologists and consulting psychiatrists.</description><subject>Aged</subject><subject>Geriatric psychology</subject><subject>Home Care Services - organization & administration</subject><subject>Home-based primary care</subject><subject>Hospitalization</subject><subject>Humans</subject><subject>Male</subject><subject>mental health</subject><subject>Mental health care</subject><subject>Mental Health Services - organization & administration</subject><subject>Patient Care Team - organization & administration</subject><subject>Primary care</subject><subject>Primary Health Care - organization & administration</subject><subject>Qualitative Research</subject><subject>United States</subject><subject>United States Department of Veterans Affairs</subject><subject>Veterans</subject><subject>Veterans Health Services - organization & administration</subject><issn>1064-7481</issn><issn>1545-7214</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kU9v1DAQxS0EoqXwBTggS1x6yeKxHcdBXJZVYSsVUUThanntCTjKP-ykUr89jrb00AOnGY1_8-R5j5DXwDbAQL1rN639NW04A50HG8bUE3IKpSyLioN8mnumZFFJDSfkRUoty0St5HNyIpjksq7LU9JdDjNGH5ILUxcGG-_oDdqeXmNME7o53GKi40C_4DDbju7RdvNvurMRaRjozy3djz0WH21CT69j6FeB9fU93dJvi-3CbFcN-n1e_N1L8qyxXcJX9_WM_Ph0cbPbF1dfP1_utleFE1rORa00U1qD80pV4FCBPigtPStrpuuG6UqWtagQheIWAK3y6BiAY4fG1b4RZ-T8qDvF8c-CaTZ9PhC7zg44LslwEEIK4CXP6NtHaDsucci_y1SleClFWWWKHykXx5QiNmY63mqAmTUL05o1C7Nmsc6y03npzb30cujRP6z8Mz8DH44AZi9uA0aTU8DBoQ8xW2_8GP6n_xdoYpjD</recordid><startdate>201902</startdate><enddate>201902</enddate><creator>Gillespie, Suzanne M.</creator><creator>Manheim, Chelsea</creator><creator>Gilman, Carrie</creator><creator>Karuza, Jurgis</creator><creator>Olsan, Tobie H.</creator><creator>Edwards, Samuel T.</creator><creator>Levy, Cari R.</creator><creator>Haverhals, Leah</creator><general>Elsevier Inc</general><general>Elsevier Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>4T-</scope><scope>K9.</scope><scope>7X8</scope></search><sort><creationdate>201902</creationdate><title>Interdisciplinary Team Perspectives on Mental Health Care in VA Home-Based Primary Care: A Qualitative Study</title><author>Gillespie, Suzanne M. ; Manheim, Chelsea ; Gilman, Carrie ; Karuza, Jurgis ; Olsan, Tobie H. ; Edwards, Samuel T. ; Levy, Cari R. ; Haverhals, Leah</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c384t-96806881cd6671ce618b684d059089f08745937ee362a11ea6dec011c0bfc9df3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Aged</topic><topic>Geriatric psychology</topic><topic>Home Care Services - organization & administration</topic><topic>Home-based primary care</topic><topic>Hospitalization</topic><topic>Humans</topic><topic>Male</topic><topic>mental health</topic><topic>Mental health care</topic><topic>Mental Health Services - organization & administration</topic><topic>Patient Care Team - organization & administration</topic><topic>Primary care</topic><topic>Primary Health Care - organization & administration</topic><topic>Qualitative Research</topic><topic>United States</topic><topic>United States Department of Veterans Affairs</topic><topic>Veterans</topic><topic>Veterans Health Services - organization & administration</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Gillespie, Suzanne M.</creatorcontrib><creatorcontrib>Manheim, Chelsea</creatorcontrib><creatorcontrib>Gilman, Carrie</creatorcontrib><creatorcontrib>Karuza, Jurgis</creatorcontrib><creatorcontrib>Olsan, Tobie H.</creatorcontrib><creatorcontrib>Edwards, Samuel T.</creatorcontrib><creatorcontrib>Levy, Cari R.</creatorcontrib><creatorcontrib>Haverhals, Leah</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Docstoc</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>The American journal of geriatric psychiatry</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Gillespie, Suzanne M.</au><au>Manheim, Chelsea</au><au>Gilman, Carrie</au><au>Karuza, Jurgis</au><au>Olsan, Tobie H.</au><au>Edwards, Samuel T.</au><au>Levy, Cari R.</au><au>Haverhals, Leah</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Interdisciplinary Team Perspectives on Mental Health Care in VA Home-Based Primary Care: A Qualitative Study</atitle><jtitle>The American journal of geriatric psychiatry</jtitle><addtitle>Am J Geriatr Psychiatry</addtitle><date>2019-02</date><risdate>2019</risdate><volume>27</volume><issue>2</issue><spage>128</spage><epage>137</epage><pages>128-137</pages><issn>1064-7481</issn><eissn>1545-7214</eissn><abstract>•What is the primary question addressed by this study?This qualitative study sought to examine the question: What are the attributes and gaps in mental health services for Veterans in the U.S. Department of Veteran's Affairs (VA) Home-Based Primary Care Program (HBPC)?•What is the main finding of this study?The study identifies four themes related to the provision of mental health care in HBPC: 1) HBPC Veterans have not only complex physical needs but also co-occurring mental needs; 2) the multi-faceted role of psychologists on HBPC teams that includes providing care for Veterans and support for colleagues; 3) collaboration between medical and mental health providers as a means of caring for HBPC Veterans with mental health needs; and 4) gaps in providing mental health care on HBPC teams, primarily related to a lack of team psychiatrists and/or need for specialized medication management for psychiatric illness.•What is the meaning of the finding?Mental health providers are an essential component of HBPC teams. Improved understanding of HBPC mental health provider models will be valuable to optimizing care of homebound adults.
This qualitative study describes the structure and processes of providing care to U.S. Department of Veterans Affairs (VA) Home-Based Primary Care (HBPC) enrollees with mental health care needs; explains the role of the HBPC psychologist; and describes how mental health treatment is integrated into care from the perspective of HBPC team members.
HBPC programs were selected for in-person site visits based on initial surveys and low hospitalization rates.
Programs varied in setting, geographic locations, and primary care model.
Eight site visits were completed. During visits, key informants including HBPC program directors, medical directors, team members, and other key staff involved with the HBPC program participated in semi-structured individual and group interviews.
Recorded interviews, focus groups, and field observation notes.
Qualitative thematic content analysis revealed four themes: 1) HBPC Veterans have not only complex physical needs but also co-occurring mental health needs; 2) the multi-faceted role of psychologists on HBPC teams, that includes providing care for Veterans and support for colleagues; 3) collaboration between medical and mental health providers as a means of caring for HBPC Veterans with mental health needs; and 4) gaps in providing mental health care on HBPC teams, primarily related to a lack of team psychiatrists and/or need for specialized medication management for psychiatric illness.
Mental health providers are essential to HBPC teams. Given the significant mental health care needs of HBPC enrollees and the roles of HBPC mental health providers, HBPC teams should integrate both psychologists and consulting psychiatrists.</abstract><cop>England</cop><pub>Elsevier Inc</pub><pmid>30424995</pmid><doi>10.1016/j.jagp.2018.10.006</doi><tpages>10</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1064-7481 |
| ispartof | The American journal of geriatric psychiatry, 2019-02, Vol.27 (2), p.128-137 |
| issn | 1064-7481 1545-7214 |
| language | eng |
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| source | MEDLINE; Alma/SFX Local Collection |
| subjects | Aged Geriatric psychology Home Care Services - organization & administration Home-based primary care Hospitalization Humans Male mental health Mental health care Mental Health Services - organization & administration Patient Care Team - organization & administration Primary care Primary Health Care - organization & administration Qualitative Research United States United States Department of Veterans Affairs Veterans Veterans Health Services - organization & administration |
| title | Interdisciplinary Team Perspectives on Mental Health Care in VA Home-Based Primary Care: A Qualitative Study |
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