The primary care companion for CNS disorders最新文献

The Psychiatric Consultation Service at Massachusetts General Hospital sees medical and surgical inpatients with comorbid psychiatric symptoms and conditions. During their twice-weekly rounds, Dr Stern and other members of the Consultation Service discuss diagnosis and management of hospitalized patients with complex medical or surgical problems who also demonstrate psychiatric symptoms or conditions. These discussions have given rise to rounds reports that will prove useful for clinicians practicing at the interface of medicine and psychiatry.

Importance: Quality improvement in community mental health care is crucial for enhancing patient outcomes and service effectiveness. However, the field faces challenges due to the heterogeneity of initiatives and limited comprehensive studies.

Observations: A search was conducted in PubMed using various combinations of the following terms: quality improvement, quality enhancement, community mental health, and community mental health services. The review included 23 studies published in English, with no publication date restrictions. The analysis identified 6 recurring themes as key components of successful quality improvement initiatives: sustainability in service delivery, community engagement for quality assurance, telehealth interventions, integration of physical and metabolic health, educational/training interventions, and policy and governance interventions.

Conclusions and Relevance: Sustainable service delivery relies on cost-effective interventions, collaborative care across governmental and nongovernmental organizations, and the integration of training and digital health solutions to promote and ensure mental well-being. Telehealth serves as a platform for mental health services, enhancing accessibility, minimizing geographical barriers, and improving service efficiency. Community engagement helps promote mental well-being and reduces mental health disparities. Educational initiatives equip professionals with the skills to address social determinants of health, strengthening their ability to deliver effective care to specific populations. Robust policies and governance are essential for strengthening the community mental health system, ensuring equity, and promoting sustainable service delivery. The findings provide valuable insights for policymakers, practitioners, and researchers seeking to improve care in community settings.

Prim Care Companion CNS Disord 2025;27(5):25nr03962.

Author affiliations are listed at the end of this article.

Objective: Patients with psychotic disorders have higher rates of medical comorbidities and premature mortality compared to the general population but have been shown to access primary care at low rates. Young adults are at risk of disengaging from primary care services during the transition to adulthood. This descriptive qualitative research study sought to explore barriers and facilitators to engaging with primary care among young adults with first-episode psychosis (FEP).

Methods: Ten patients aged 18-30 years receiving care in a coordinated specialty care clinic for FEP were recruited from October 2021 to December 2022. Participants were interviewed using a semistructured interview guide. Interviews were recorded and transcribed. A codebook was created inductively using data from the transcripts, and themes were generated from group consensus.

Results: Two themes relating to access to primary care were identified: (1) barriers, which included scheduling conflicts and missed appointments, active mental illness symptoms, and difficulties in rapport with the primary care physician (PCP) and (2) facilitators, which included proximity to home, absence of financial barriers, availability of urgent appointments, and caring, nonjudgmental attitudes of the PCP.

Conclusion: Improving engagement in primary care is critical for young adults with FEP to establish beneficial patterns of health care use and timely access to preventative care. This study identifies factors that may help facilitate care with PCPs, which could increase timely utilization of medical care and reduce premature mortality within this vulnerable population.

Prim Care Companion CNS Disord 2025;27(5):25m03974.

Author affiliations are listed at the end of this article.

The Psychiatric Consultation Service at Massachusetts General Hospital sees medical and surgical inpatients with comorbid psychiatric symptoms and conditions. During their twice-weekly rounds, Dr Stern and other members of the Consultation Service discuss diagnosis and management of hospitalized patients with complex medical or surgical problems who also demonstrate psychiatric symptoms or conditions. These discussions have given rise to rounds reports that will prove useful for clinicians practicing at the interface of medicine and psychiatry.

Prim Care Companion CNS Disord 2025;27(5):25f03968.

Author affiliations are listed at the end of this article.