Moving beyond stepped care to staged care using a novel, technology‐enabled care model for youth mental health

2019 ◽  
Vol 211 (9) ◽  
pp. 404-405 ◽  
Author(s):  
Ian B Hickie
2019 ◽  
Vol 211 (S9) ◽  
Author(s):  
Ian B Hickie ◽  
Elizabeth M Scott ◽  
Shane P Cross ◽  
Frank Iorfino ◽  
Tracey A Davenport ◽  
...  

2019 ◽  
Vol 10 ◽  
Author(s):  
Beata Trilesnik ◽  
Umut Altunoz ◽  
Janina Wesolowski ◽  
Leonard Eckhoff ◽  
Ibrahim Ozkan ◽  
...  

Health Equity ◽  
2020 ◽  
Vol 4 (1) ◽  
pp. 484-488
Author(s):  
Christina Bricca DiSanza ◽  
Pamela A. Geller ◽  
Alexa Bonacquisti ◽  
Bobbie Posmontier ◽  
June Andrews Horowitz ◽  
...  

2004 ◽  
Vol 185 (4) ◽  
pp. 283-290 ◽  
Author(s):  
Graham Thornicroft ◽  
Michele Tansella

BackgroundThere is controversy about whether mental health services should be provided in community or hospital settings. There is no worldwide consensus on which mental health service models are appropriate in low-, medium- and high-resource areas.AimsTo provide an evidence base for this debate, and present a stepped care model.MethodCochrane systematic reviews and other reviews were summarised.ResultsThe evidence supports a balanced approach, including both community and hospital services. Areas with low levels of resources may focus on improving primary care, with specialist back-up. Areas with medium resources may additionally provide out-patient clinics, community mental health teams (CMHTs), acute in-patient care, community residential care and forms of employment and occupation. High-resource areas may provide all the above, together with more specialised services such as specialised out-patient clinics and CMHTs, assertive community treatment teams, early intervention teams, alternatives to acute in-patient care, alternative types of community residential care and alternative occupation and rehabilitation.ConclusionsBoth community and hospital services are necessary in all areas regardless of their level of resources, according to the additive and sequential stepped care model described here.


Author(s):  
Joel Paris

Psychotherapy can be integrated into the practice of psychiatry, but doing so requires changes in how mental health services are currently delivered. The delivery of psychiatric services may not be ideally accomplished in solo office practice but often requires multidisciplinary teams that include psychologists and social workers. This model of health care requires structures and planning that focuses on the needs of the sickest patients in the mental health system. Psychiatrists should reserve providing direct care for this population. Applying a stepped care model, one can offer less intensive treatment as a first step, reserving resource-intensive rehabilitation methods as a second step for those who do not improve. The benefits of this approach are that it avoids using specialized resources on patients who will get better with less intensive and briefer interventions and it supports clinical psychologists in the treatment of common mental disorders.


2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S512-S513
Author(s):  
Terry Lum ◽  
Gloria Wong ◽  
Tianyin Liu ◽  
Shiyu Lu ◽  
Dara Leung ◽  
...  

Abstract Background: Depression is common among older adults and creates a substantial burden on individuals, caregivers, and healthcare system. This paper presents an innovative collaborative stepped care intervention that promotes the coordination between elderly center and community mental health center to provide nonpharmacological intervention to elders with mild to moderate level of depression. Methods: The stepped care model were implemented in four districts in Hong Kong between September 2017 and February 2019. In each district, one community mental health center and one elderly center worked together to implement this stepped care model. A quasi-experimental design was used to study the effectiveness of this intervention. Findings: A total of 853 older adults completed the intervention and additional 500 elders were recruited as control. The average age of intervention participants was 76.3 years. Their levels of depression and anxiety were measured by Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder 7-item (GAD-7) respectively. The average intervention lasted for 10 months. Their average PhQ9 score reduced from 7.2 before intervention to 2.7 after intervention (t= 34.7, p < .001). Their level of anxiety was lowered from 4.9 to 2.0 (t=16.9, p < .001). The different between the intervention and control groups were statistically significant. Conclusion: The stepped care model was effective in reducing the levels of depression and anxiety among Chinese older people. This paper will give detailed information about the stepped care model and its implementation.


2009 ◽  
Author(s):  
Chris Slaten ◽  
Thomas W. Baskin ◽  
Jaquaye L. Glover ◽  
Carey Sorenson

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