Towards integrated medical and mental healthcare in the inpatient setting: what is the role of psychology?

Int Rev Psychiatry. 2018 Dec;30(6):210-223. doi: 10.1080/09540261.2018.1552125. Epub 2019 Mar 1.

Abstract

Integrated medical and psychiatric hospital units hold great promise for improving the value and quality of care for patients with severe mental illness and concomitant acute medical needs. It is important to explore the utility of providing a range of multidisciplinary inpatient services to meet patients' complex needs. Within this context, services typically provided by psychologists have received little research attention. To address this gap in the literature, this study assessed inpatient clinicians' perceptions of the need for specific behavioural services on a medical psychiatric unit, exploring their overlap with established psychological services. Results indicate the potential utility of specific psychological services, including psychological assessments, direct psychosocial interventions, and psychoeducational training. While reimbursement and billing barriers still exist for psychologists to be routinely incorporated into hospital settings, the movement towards value-based care could provide the opportunity to think about the value added. Embedding evidence-based psychological services has the potential to promote high quality, well-rounded care that aligns with the established mission of multidisciplinary teamwork on integrated medical and psychiatric inpatient units.

Keywords: Collaborative care; inpatient psychiatry; integrated care; medical psychiatric units; psychological services.

MeSH terms

  • Attitude of Health Personnel
  • Chronic Disease / therapy*
  • Cooperative Behavior
  • Delivery of Health Care, Integrated / organization & administration*
  • Humans
  • Inpatients*
  • Mental Health Services / organization & administration*
  • Psychology*