Integrating mental health care into primary care for adolescentsand young adults: systematic review
General practitioners, as primary care specialists, often play a key role in the prevention, early detection and treatment of mental health (MH) disorders. Early detection and care are especially important for adolescents and young adults, as the majority of mental disorders start before the age of 25. However, the specific aspects of the physician-young patient relationship poses challenges to the integration of MH issues in general practice with young adults. As a result, emerging MH disorders are often underdiagnosed in this population, preventing or delaying care that may improve MH, prevent complications, and limit evolution toward chronic condition.
In the past decades, the concept of integrated care has been promoted as a lever for improving primary health care, with objectives that can be broken down into: 1) clinical integration (aiming at continuity of care, i.e. “seamless service” or “continuous caring relationship”); 2) professional integration; 3) organizational integration; and 4) system integration.
To investigate the potential of this concept to improve mental health primary care, we performed a systematic review of the PubMed, PsycInfo and PubPsych databases, following the PRISMA recommendations, to identify and compare interventions integrating MH services into primary care for 12-25 year-old patients. A specific focus was given to continuity of service and professional integration between primary care and MH professionals.
The strategies implemented to integrate MH care into primary care for young patients were heterogeneous, and depended on local resources and health system. Preliminary analysis identified four main organizational types: “collaborative co-locations”, “collaborations without co-location”, “one stop shops”, and “MH care resources for primary care”. Few interventions were evaluated. Professional integration ranged from simple referral to regular interactions between professionals.
The diversity of approaches identified call for detailed investigations and report of the contextual factors and constraints that led to the design of each intervention.
In the past decades, the concept of integrated care has been promoted as a lever for improving primary health care, with objectives that can be broken down into: 1) clinical integration (aiming at continuity of care, i.e. “seamless service” or “continuous caring relationship”); 2) professional integration; 3) organizational integration; and 4) system integration.
To investigate the potential of this concept to improve mental health primary care, we performed a systematic review of the PubMed, PsycInfo and PubPsych databases, following the PRISMA recommendations, to identify and compare interventions integrating MH services into primary care for 12-25 year-old patients. A specific focus was given to continuity of service and professional integration between primary care and MH professionals.
The strategies implemented to integrate MH care into primary care for young patients were heterogeneous, and depended on local resources and health system. Preliminary analysis identified four main organizational types: “collaborative co-locations”, “collaborations without co-location”, “one stop shops”, and “MH care resources for primary care”. Few interventions were evaluated. Professional integration ranged from simple referral to regular interactions between professionals.
The diversity of approaches identified call for detailed investigations and report of the contextual factors and constraints that led to the design of each intervention.