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Office of the Surgeon General (US). Report of a Surgeon General's Working Meeting on The Integration of Mental Health Services and Primary Health Care: Held on November 30-December 1, 2000, at the Carter Center: Atlanta, Georgia. Rockville (MD): Office of the Surgeon General (US); 2001.

Cover of Report of a Surgeon General's Working Meeting on The Integration of Mental Health Services and Primary Health Care

Report of a Surgeon General's Working Meeting on The Integration of Mental Health Services and Primary Health Care: Held on November 30-December 1, 2000, at the Carter Center: Atlanta, Georgia.

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Recommendations Toward Core Principles

Meeting participants agreed to the following principles-or fundamental elements required to facilitate the development and implementation of programs that integrate mental health services and primary health care. They provide a framework, not only for local programs, but also for a National initiative.

  1. Emphasis on Consumers and Their Families. The needs of mental health consumers and their families should drive service delivery and systems of care. Cultural and ethnic diversity should be respected. The integration of mental health and primary care is meant to expand access to care and is not intended to preclude availability of mental health specialty care for those who need it.
  2. Promoting Health and Overcoming Disparities. Promote health for all Americans and overcome disparities in the burden of illness and death experienced by African Americans, Hispanics, Native Americans, Alaska Natives, and Asians and Pacific Islanders.
  3. Basic Characteristics. Research, training, and practice should incorporate consumer, family, and professional partnerships; cross-disciplinary professional collaborations; population-based health care; a holistic approach to health care; and respect for, and understanding the role of, spirituality and alternative medicine/traditional healing practices.
  4. Financial Incentives for Team Approach. New types of financial incentives should be offered to encourage team approaches to care. The team includes consumers and families, primary care providers, mental health professionals, and nursing case managers. The team may also include care management, consultation, and specialty services.
  5. Reimbursement. Reimbursement should be designed to support evidence-based care.
  6. Collaboration/Colocation. Integrated service delivery should be guided by a commitment to collaboration or colocation of services.
  7. Chronic Illness, Continuity of Care. Integrated service delivery should feature the treatment of chronic illness and continuity of care.
  8. Standardized Quality and Outcome Measures. Quality and outcome measures should be standardized across systems and levels of care and include consumer/family participation. The collection of information should respect consumer and family privacy. The information should be transportable and longitudinal.
  9. Building on Existing Models. The development of integrated programs should build on existing knowledge and/or models of care.
  10. Research and Demonstrations. Research findings must be salient to key stakeholders, including diverse ethnic and cultural communities. Successful research and demonstration programs should be sustainable through multifaceted partnerships brokered by funding agencies.
  11. Investment in Training. Training should build collaborative partnerships that are grounded in clinical and systemic decision making of the highest quality. Quality should reflect evidence-based knowledge that is disseminated in culturally sensitive ways to promote health and reduce stigma.
  12. Information Technology. Information technology should be marshaled as a tool for communication, patient education, data collection, and access to care. This technology should support the infrastructure needed to deliver high-quality care while protecting patient and family confidentiality.

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