Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2021 Sep 14:2:26334895211041294.
doi: 10.1177/26334895211041294. eCollection 2021 Jan-Dec.

Transitioning patients from outpatient mental health services to primary care: A rapid literature review

Paula R Blasi  1 , Kayne D Mettert  1 , Katie Coleman  1 , Cara Lewis  1 , Edward Wagner  1 , Maria N Coghill  2 , Tobias Dang  2 , Julie E Richards  1   3
Affiliations
Review

Transitioning patients from outpatient mental health services to primary care: A rapid literature review

Paula R Blasi et al. Implement Res Pract. .

Abstract

Background: A lack of access to mental health services is a critical barrier to obtaining evidence-based care. One strategy to improve access is to transition stable patients out of mental health specialty services and into primary care, thus opening availability for new patients and those with acute mental health needs. To support these transitions, organizations might explore a range of new practices and implementation strategies.

Methods: We conducted a rapid literature review to summarize descriptions from the research literature about practices for transitioning stable patients from outpatient mental health services to primary care, as well as implementation strategies to enhance the adoption and sustainment of these practices. We searched PsycINFO and Cumulated Index to Nursing and Allied Health Literature (CINAHL) for articles published between January 2000 and August 2019. For articles meeting inclusion criteria, we abstracted data on study characteristics, transition practices, and implementation strategies.

Results: We included 11 articles representing diverse study designs, settings, and health care organizations. Across these articles, we identified six categories of commonly described transition practices, with patient engagement appearing the most frequently (10 articles), followed by shared treatment planning (eight articles), assessment of recovery and stability, care coordination, follow up and support, and medication management (seven articles each). Less frequently, articles included descriptions of implementation strategies, with five articles describing efforts to train and educate stakeholders and four articles describing the use of evaluative and iterative strategies.

Conclusions: We identified descriptions of several common practices to help patients transition from mental health specialty services to primary care, but there are opportunities for an increased focus on implementation strategies to enhance the adoption and sustainment of these transition practices. More research is needed to better understand the effectiveness of specific transition interventions and the feasibility of deploying these interventions in heterogeneous health care settings.

Keywords: Mental health; evidence-based care; implementation strategies; primary care; sustainment.

PubMed Disclaimer

Conflict of interest statement

The authors declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Transitioning patients from outpatient mental health services to primary care: A rapid literature review Co-author Cara Lewis is a co-founding editor of Implementation Research and Practice.

Figures

Figure 1.
Figure 1.
Literature flow diagram.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Andrilla C. H. A., Patterson D. G., Garberson L. A., Coulthard C., Larson E. H. (2018). Geographic variation in the supply of selected behavioral health providers. American Journal of Preventive Medicine, 54(6 Suppl 3), S199–S207. 10.1016/j.amepre.2018.01.004 - DOI - PubMed
    1. Auerbach J., Miller B. F. (2020). COVID-19 exposes the cracks in our already fragile mental health system. American Journal of Public Health, 110(7), e1–e2. 10.2105/AJPH.2020.305699 - DOI - PMC - PubMed
    1. Berkowitz S. A., Parashuram S., Rowan K., Andon L., Bass E. B., Bellantoni M., Brotman D. J., Deutschendorf A., Dunbar L., Durso S. C., Everett A., Giuriceo K. D., Hebert L., Hickman D., Hough D. E., Howell E. E., Huang X., Lepley D., Leung C., …, Brown P. M. C. (2018). Association of a care coordination model with health care costs and utilization: The Johns Hopkins community health partnership (J-CHiP). JAMA Network Open, 1(7), e184273. 10.1001/jamanetworkopen.2018.4273 - DOI - PMC - PubMed
    1. Bishop T. F., Seirup J. K., Pincus H. A., Ross J. S. (2016). Population of US practicing psychiatrists declined, 2003–13, which may help explain poor access to mental health care. Health Affairs, 35(7), 1271–1277. 10.1377/hlthaff.2015.1643 - DOI - PubMed
    1. Brodsky B. S., Spruch-Feiner A., Stanley B. (2018). The zero suicide model: Applying evidence-based suicide prevention practices to clinical care. Frontiers in Psychiatry, 9, 33. 10.3389/fpsyt.2018.00033 - DOI - PMC - PubMed

LinkOut - more resources