Integrating bipolar disorder management in primary care

Curr Psychiatry Rep. 2012 Dec;14(6):687-95. doi: 10.1007/s11920-012-0325-4.

Abstract

There is growing realization that persons with bipolar disorder may exclusively be seen in primary (general medical) care settings, notably because of limited access to mental health care and stigma in seeking mental health treatment. At least two clinical practice guidelines for bipolar disorder recommend collaborative chronic care models (CCMs) to help integrate mental health care to better manage this illness. CCMs, which include provider guideline support, self-management support, care management, and measurement-based care, are well-established in primary care settings, and may help primary care practitioners manage bipolar disorder. However, further research is required to adapt CCMs to support complexities in diagnosing persons with bipolar disorder, and integrate decision-making processes regarding medication safety and tolerability in primary care. Additional implementation studies are also needed to adapt CCMs for persons with bipolar disorder in primary care, especially those seen in smaller practices with limited infrastructure and access to mental health care.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.
  • Review

MeSH terms

  • Bipolar Disorder* / diagnosis
  • Bipolar Disorder* / epidemiology
  • Bipolar Disorder* / therapy
  • Chronic Disease / therapy
  • Cost of Illness
  • Health Services Accessibility
  • Health Services Needs and Demand / economics
  • Health Services Needs and Demand / organization & administration
  • Humans
  • Mental Health Services / economics
  • Mental Health Services / organization & administration*
  • Practice Guidelines as Topic
  • Primary Health Care / economics
  • Primary Health Care / organization & administration*
  • United States / epidemiology