Families, systems & health : the journal of collaborative family healthcare
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The redesign of primary care through the patient-centered medical home offers an opportunity to assess the role of primary care in treating mental health relative to the rest of the health care system. Better understanding the patterns of care between primary care and mental health providers helps guide necessary policy changes. ⋯ Our findings indicate that poor mental health and specific mental health conditions remain prevalent in primary care. An increased focus on patient-centered care requires greater integration of primary and mental health care to reduce fragmentation of care and disparities in health outcomes.
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Comments on the article "Joint principles: Integrating behavioral health care into the patient-centered medical home" (see record 2014-24217-011). The American College of Physicians (ACP) supports the intent of these "Joint Principles" for behavioral health care and agrees that the incorporation of behavioral health care within the patient-centered medical home model is incomplete. ACP believes that these principles should be labeled as guidelines, rather than Joint Principles. ACP is also concerned with the use of overgeneralizations within the document that do not include a cited evidence base.
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Family members and friends can be an important source of self-management support for older adults with chronic diseases. We characterized the U. S. population of potential and current "disease management supporters" for people with chronic illness who are independent in activities of daily living, the help that supporters could provide, and barriers to increasing support. ⋯ The majority of U. S. adults already helps, or would be willing to help, one of their family members or friends with chronic illness care. Supporters' specific concerns could be addressed through innovative programs.
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This special issue discusses the ethical issues providers face in collaborative primary care settings. It is organized in three sections: (a) Common Themes, (b) Context-Specific Quandaries, and (c) Research and Training. It provides case examples to illustrate ethical dilemmas, describe professional ethical standards pertinent to the case, identifies gaps in available guidance and how guidelines might be elucidated in state statues (without going into detail about specific states), offers feasible recommendations to BHCs for deciding an ethical course when extant guidance was lacking, and then demonstrates and applies the recommendations to achieve an ethical resolution to the case example.