Ashleigh Holmes, Yu-Ping Chang published in Family Practice journal

PhD student Ashleigh Holmes, along with co-author Yu-Ping Chang, senior associate dean and professor in the School of Nursing, was published in the journal Family Practice last month. Their integrative review, “Effect of Mental Health Collaborative Care Models on Primary Care Provider Outcomes,” synthesizes evidence of the impacts of the mental health collaborative care model on primary care provider outcomes. This is of particular importance as the prevalence of mental health disorders in the United States continues to rise, coupled with a shrinking primary care provider workforce.

According to the National Alliance on Mental Illness, nearly 20% of adults and 17% of children experience a mental health disorder, but only about half of patients receive care.

Primary care providers often manage mental health diagnoses, especially in rural and medically underserved areas. According to the authors, these providers report unsatisfactory relationships with mental health providers and also note that caring for patients with mental health disorders without the support of a team contributes to burnout – this, in turn, contributes to the primary care provider shortage and decreased quality of patient care.

The authors say that a collaborative care model may help to improve patient outcomes and could potentially improve provider outcomes, though more research regarding provider outcomes is needed.

Holmes and Chang identified five themes from the literature:

1. Overall positive effect of collaborative care models on provider-level outcomes, including increased comfort in managing mental health diagnoses.
2. Improved collaboration and communication among team members.
3. Logistical barriers to implementing collaborative care models, such as scheduling conflicts and space limitations.
4. The adaptability of collaborative care models to fit diverse settings and patient populations.
5.  Primary care provider differences and concerns, including scope of practice and duplicity of work.

The authors conclude that there is accumulating evidence to support implementation of collaborative care models to improve patient and provider outcomes, as this model “overwhelmingly improved [primary care provider] outcomes, interprofessional collaboration and communication.”

They also write that primary care providers reported “increased knowledge, comfort, self-efficacy, self-rated quality of care, satisfaction, confidence, and efficiency in managing patients with mental health diagnoses.”

The increased need for mental health care in the United States coupled with growing primary care provider shortage necessitates solutions – such as the collaborative care model – that improve the quality of care for patients experiencing mental health disorders while also improving provider outcomes.

-Sarah Goldthrite