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Conference Abstracts

Interventions to integrate physical and mental healthcare for people with serious mental illness and/or substance use disorders: a systematic scoping review

Author:

Amy Richardson

University Of Otago, NZ
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Abstract

Introduction:

People with serious mental illness (SMI) and/or substance use disorders (SUDs) have an elevated risk of premature mortality compared to the general population. This has been attributed to higher rates of chronic illness among these individuals, but also to inequities in healthcare access and treatment. Integrated care has the potential to improve the health of people with SMI/SUDs.

Theory/Methods:

 A scoping review has been conducted to: 1) identify empirical investigations of interventions designed to integrate physical and mental healthcare for people with SMI/SUDs, 2) describe the underlying theories, models, and frameworks of integrated care that informed their development, and 3) determine the degree to which interventions address dimensions of a comprehensive and validated framework of integrated care. An iterative and systematic search of peer-reviewed publications reporting empirical research findings was performed by searching five databases: Medline (Ovid), PsycINFO, CINAHL, Embase (Ovid), and Scopus.

Results:

Following the removal of duplicates, 6,696 publications were identified from the search. Using predetermined inclusion criteria, two reviewers independently screened titles and abstracts for eligibility, followed by a review of full texts. This resulted in the final inclusion of 28 publications, representing 25 unique studies. Thirteen studies reported a theoretical model of integrated care that underpinned the intervention being tested. While coordination within and across care teams was incorporated into the majority of interventions examined, several other aspects of integrated care were frequently overlooked.

Discussions:

This presentation identifies the number and nature of interventions to integrate physical and mental healthcare for people with SMI/SUDs. Planning and interpretation of findings is guided by a team of relevant stakeholders, including people with lived experience of mental health conditions, mental health professionals, other health professionals, and researchers from a range of disciplines.

Conclusions:

Despite substantial research in this area, many interventions designed to integrate physical and mental healthcare for people with SMI/SUDs have not been informed by a theory, model, or framework of integrated care. Furthermore, a number of dimensions of integrated care have not been incorporated into interventions for this population. 

Lessons learned:

Given the significance of the inequities in health and mortality for people with SMI/SUDs, an understanding of the degree to which interventions are meeting key components of successful integrated care delivery is extremely important. This review identifies aspects of integrated care that require attention in future research examining the potential of integrated physical and mental healthcare for people with SMI/SUDs, such as coordination with community resources, continuous familiarity with service users over time, and the delivery of person-centred care.

Limitations:

The review is restricted to studies conducted in OECD countries and to articles published in English. No quality appraisals of included studies have been completed, precluding conclusions about the effectiveness of different integrated care approaches at improving outcomes.

Suggestions for future research: Stakeholders’ knowledge and interpretations of the review findings will identify clear priorities for future research examining the integration of physical and mental healthcare among people with SMI/SUDs.

How to Cite: Richardson A. Interventions to integrate physical and mental healthcare for people with serious mental illness and/or substance use disorders: a systematic scoping review. International Journal of Integrated Care. 2021;21(S1):69. DOI: http://doi.org/10.5334/ijic.ICIC2051
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Published on 01 Sep 2021.

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