Opinion Review
Copyright ©The Author(s) 2021.
World J Psychiatr. Jul 19, 2021; 11(7): 271-276
Published online Jul 19, 2021. doi: 10.5498/wjp.v11.i7.271
Table 1 Recommendations to improve treatment of common mental health conditions in primary care settings
(1) ACGME requirements should be amended to require dedicated time for primary care physicians to learn self-care/burnout prevention as well as basic problem-solving therapy and psychopharmacological care on outpatient psychiatry rotations or through internal medicine resident-run mental health clinics and for psychiatrists to learn how to supervise other clinicians, including but not limited to: social workers, psychologists, and primary care doctors who function as the primary prescribers; (2) Health systems should streamline communications systems (pagers, cellphones, telehealth) to create access to e-consultations for primary care doctors needing psychiatric expertise; (3) Financial models should align with the long-term need for indirect consultations as well as with new roles of primary care providers and psychiatrists within integrated care settings particularly in the post-COVID-19 financial milieu; (4) Integrated care models should leverage technology to fill administrative functions (such as tracking patient health questionnaire (PHQ-9 forms), develop guidelines for determining when and how to use smartphone treatment applications and self-care resources in primary care settings, and rapidly expand telemedicine to address workforce gaps particularly in socioeconomically disadvantaged groups who face technology-driven disparities; (5) Primary care practices must partner with psychiatry specialty services to create a robust process for referring appropriate patients to specialty mental health care; and (6) Real world effectiveness research should be conducted to elucidate the effectiveness of precisely and efficiently targeting screening and treatment recommendations according to patient phenotype, risk and preference