Collaborative mental health and primary care for bipolar disorder.
This article discusses the use of integrated care models, in particular, collaborative care, in the treatment of bipolar disorder. Dr. Williams first discusses how care delivered via a collaboration between primary care and psychiatric providers has the potential to improve both mental health and general medical outcomes for patients with bipolar disorder. He describes promising findings from studies of the use of collaborative care in the treatment of depression, an area where this model has received the most study. Dr. Williams then discusses how such collaborative care models might best be implemented in the treatment of bipolar disorder. In the second half of the article, Dr. Manning focuses on five key issues that are an especially appropriate focus for collaborative care for bipolar disorder and for which the STAndards for BipoLar Excellence (STABLE) Project developed quality improvement performance measures: assessment for risk of suicide, assessment for substance use/abuse, monitoring for extrapyramidal symptoms, monitoring of metabolic parameters (e.g., monitoring for weight gain, hyperglycemia, hyperlipidemia), and provision of bipolar-specific psychoeducation.
Williams
John W
JW
Duke University Medical Center, Durham VAMC, 2424 Erwin Road, Suite 1105, Durham, NC 27705, USA. willi007@mc.duke.edu
Manning
J Sloan
JS
D001714:Bipolar Disorder / Q000150:complications / Q000628:therapy*; D019033:Delivery of Health Care, Integrated / Q000458:organization & administration*; D006801:Humans; D008605:Mental Health Services / Q000458:organization & administration*; D011320:Primary Health Care / Q000458:organization & administration*; D019984:Quality Indicators, Health Care; D016896:Treatment Outcome