title: Integrating primary care and behavioral health with four special populations: Children with special needs, people with serious mental illness, refugees, and deaf people.
abstract: Special patient populations can present unique opportunities and challenges to integrating primary care and behavioral health services. This article focuses on four special populations: children with special needs, persons with severe and persistent mental illness, refugees, and deaf people who communicate via sign language. The current state of primary care and behavioral health collaboration regarding each of these four populations is examined via Doherty, McDaniel, and Baird's (1996) five-level collaboration model. The section on children with special needs offers contrasting case studies that highlight the consequences of effective versus ineffective service integration. The challenges and potential benefits of service integration for the severely mentally ill are examined via description of PRICARe (Promoting Resources for Integrated Care and Recovery), a model program in Colorado. The discussion regarding a refugee population focuses on service integration needs and emerging collaborative models as well as ways in which refugee mental health research can be improved. The section on deaf individuals examines how sign language users are typically marginalized in health care settings and offers suggestions for improving the health care experiences and outcomes of deaf persons. A well-integrated model program for deaf persons in Austria is described. All four of these special populations will benefit from further integration of primary care and mental health services.
authors.affiliation: Department of Psychiatry, University of Rochester Medical Center.
authors.forename: Robert Q
authors.initials: RQ
authors.lastname: Pollard
authors.affiliation: Department of Pediatrics, University of Colorado Denver School of Medicine.
authors.forename: William R
authors.initials: WR
authors.lastname: Betts
authors.affiliation: Department of Family Medicine, University of Rochester Medical Center.
authors.forename: Jennifer K
authors.initials: JK
authors.lastname: Carroll
authors.affiliation: Departments of Psychiatry and Family Medicine, University of Colorado Denver School of Medicine.
authors.forename: Jeanette A
authors.initials: JA
authors.lastname: Waxmonsky
authors.affiliation: Department of Family Medicine, University of Rochester Medical Center.
authors.forename: Steven
authors.initials: S
authors.lastname: Barnett
authors.affiliation: Department of Family Medicine, University of Colorado Denver School of Medicine.
authors.forename: Frank V
authors.initials: FV
authors.lastname: deGruy
authors.affiliation: Department of Family Medicine, University of Colorado Denver School of Medicine.
authors.forename: Laura L
authors.initials: LL
authors.lastname: Pickler
authors.affiliation: Department of Community and Behavioral Health, Colorado School of Public Health.
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Kellar-Guenther
mesh_terms: D002648:Child; D019033:Delivery of Health Care, Integrated / Q000592:standards*; D019988:Children with Disabilities / Q000534:rehabilitation*; D006801:Humans; D008605:Mental Health Services / Q000592:standards*; D028642:Persons with Psychiatric Disorders; D019986:Persons with Hearing Disabilities / Q000534:rehabilitation*; D011320:Primary Health Care / Q000592:standards*; D012036:Refugees