title: Barriers and Enablers to Integrating Mental Health into Primary Care: A Policy Analysis.
abstract: Integrating care for physical health and behavioural health (mental health and addictions) has been a longstanding challenge, although research supports the clinical and cost effectiveness of integrated care for many clients. In one such model, primary care (PC) physicians work with specialist physicians and non-physician providers (NPPs) to provide mental health and addictions care in PC settings. This Ontario, Canada-focused policy analysis draws on research evidence to examine potential barriers and enablers to this model of integrated care, focusing on mental health. Funding challenges pertain to incentivizing PC physicians to select patients with mental illness, include NPPs on the treatment team, and collaborate with specialist providers. Legal/regulatory challenges pertain to NPP scopes of practice for prescribing and counselling. Integrated care also requires revising the role of the physician and distribution of functions among the team. Policy support to integrate addictions treatment in PC may face similar challenges but requires further exploration.
authors.affiliation: Institute of Health Policy, Management and Evaluation, University of Toronto, 155 College Street, Suite 425, Toronto, Ontario, M5T 3M6, Canada. Anna.durbin@gmail.com.
authors.forename: Anna
authors.initials: A
authors.lastname: Durbin
authors.affiliation: Provincial System Support Program, Center for Addiction and Mental Health, 33 Russell Street, Toronto, Ontario, M5S 2S1, Canada. Janet.Durbin@camh.ca.
authors.forename: Janet
authors.initials: J
authors.lastname: Durbin
authors.affiliation: Institute of Health Policy, Management and Evaluation, University of Toronto, 155 College Street, Suite 425, Toronto, Ontario, M5T 3M6, Canada. jennifer.hensel@mail.utoronto.ca.|Center for Addiction and Mental Health, 33 Russell Street, Toronto, Ontario, M5S 2S1, Canada. jennifer.hensel@mail.utoronto.ca.
authors.forename: Jennifer M
authors.initials: JM
authors.lastname: Hensel
authors.affiliation: Institute of Health Policy, Management and Evaluation, University of Toronto, 155 College Street, Suite 425, Toronto, Ontario, M5T 3M6, Canada. raisa.deber@utoronto.ca.
authors.forename: Raisa
authors.initials: R
authors.lastname: Deber
mesh_terms: D002170:Canada; D006291:Health Policy; D006801:Humans; D001523:Mental Disorders / Q000628:therapy*; D008603:Mental Health; D008605:Mental Health Services; D010348:Patient Care Team; D011050:Policy Making; D011320:Primary Health Care
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