Stepped Care 2.0: A Paradigm Shift in Mental Health

Stepped Care 2.0: A Paradigm Shift in Mental Health
Author: Peter Cornish
Publisher: Springer Nature
Total Pages: 148
Release: 2020-06-13
Genre: Psychology
ISBN: 3030480550

This book is a primer on Stepped Care 2.0. It is the first book in a series of three. This primer addresses the increased demand for mental health care by supporting stakeholders (help-seekers, providers, and policy-makers) to collaborate in enhancing care outcomes through work that is both more meaningful and sustainable. Our current mental health system is organized to offer highly intensive psychiatric and psychological care. While undoubtedly effective, demand far exceeds the supply for such specialized programming. Many people seeking to improve their mental health do not need psychiatric medication or sophisticated psychotherapy. A typical help seeker needs basic support. For knee pain, a nurse or physician might first recommend icing and resting the knee, working to achieve a healthy weight, and introducing low impact exercise before considering specialist care. Unfortunately, there is no parallel continuum of care for mental health and wellness. As a result, a person seeking the most basic support must line up and wait for the specialist along with those who may have very severe and/or complex needs. Why are there no lower intensity options? One reason is fear and stigma. A thorough assessment by a specialist is considered best practice. After all, what if we miss signs of suicide or potential harm to others? A reasonable question on the surface; however, the premise is flawed. First, the risk of suicide, or threat to others, for those already seeking care, is low. Second, our technical capacity to predict on these threats is virtually nil. Finally, assessment in our current culture of fear tends to focus more on the identification of deficits (as opposed to functional capacities), leading to over-prescription of expensive remedies and lost opportunities for autonomy and self-management. Despite little evidence linking assessment to treatment outcomes, and no evidence supporting our capacity to detect risk for harm, we persist with lengthy intake assessments and automatic specialist referrals that delay care. Before providers and policy makers can feel comfortable letting go of risk assessment, however, they need to understand the forces underlying the risk paradigm that dominates our society and restricts creative solutions for supporting those in need.

Health Professions Education

Health Professions Education
Author: Institute of Medicine
Publisher: National Academies Press
Total Pages: 191
Release: 2003-07-01
Genre: Medical
ISBN: 030913319X

The Institute of Medicine study Crossing the Quality Chasm (2001) recommended that an interdisciplinary summit be held to further reform of health professions education in order to enhance quality and patient safety. Health Professions Education: A Bridge to Quality is the follow up to that summit, held in June 2002, where 150 participants across disciplines and occupations developed ideas about how to integrate a core set of competencies into health professions education. These core competencies include patient-centered care, interdisciplinary teams, evidence-based practice, quality improvement, and informatics. This book recommends a mix of approaches to health education improvement, including those related to oversight processes, the training environment, research, public reporting, and leadership. Educators, administrators, and health professionals can use this book to help achieve an approach to education that better prepares clinicians to meet both the needs of patients and the requirements of a changing health care system.

Primary Care

Primary Care
Author: Barbara Starfield
Publisher: Oxford University Press, USA
Total Pages: 284
Release: 1992
Genre: Medical
ISBN:

This comprehensive work provides a lucid examination of the difficult problems that arise with the implementation of effective primary care. The book has four purposes: to help practitioners of primary care understand what they do and why; to provide a basis for the training of primary care practitioners; to stimulate research that will provide a more substantive basis for improvements in primary care; and to help policy makers understand the difficulties and challenges of primary care and its importance. In addition to discussing systems of primary care and alternative ways of evaluating them, the author addresses important issues such as practitioner-patient communication, information systems and medical records, referral processes, personnel, managed care, financing, quality assessment and community orientation. This unique volume provides a clear and valuable assessment of the basic concepts, issues and challenges in this increasingly important field.

Fostering Rapid Advances in Health Care

Fostering Rapid Advances in Health Care
Author: Institute of Medicine
Publisher: National Academies Press
Total Pages: 108
Release: 2002-12-19
Genre: Medical
ISBN: 0309087074

In response to a request from the Secretary of the Department of Health and Human Services, the Institute of Medicine convened a committee to identify possible demonstration projects that might be implemented in 2003, with the hope of yielding models for broader health system reform within a few years. The committee is recommending a substantial portfolio of demonstration projects, including chronic care and primary care demonstrations, information and communications technology infrastructure demonstrations, health insurance coverage demonstrations, and liability demonstrations. As a set, the demonstrations address key aspects of the health care delivery system and the financing and legal environment in which health care is provided. The launching of a carefully crafted set of demonstrations is viewed as a way to initiate a "building block" approach to health system change.