An Approach to Collaborative Care and Consultation: Interviewing, Cultural Competence, and Enhancing Rapport and Adherence - 04/08/11

Doi : 10.1016/j.mcna.2010.08.001

B.J. Beck, MSN, MD ^a,^b,^c,^⁎ , Christopher Gordon, MD ^a,^d,^e
^a Department of Psychiatry, Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA
^b Robert B. Andrews Unit, Massachusetts General Hospital, 15 Parkman, Boston, MA 02114, USA
^c Medical Affairs, Beacon Health Strategies, LLC, 500 Unicorn Park Drive #401, Woburn, MA 01801, USA
^d Advocates, Inc, One Clarks Hill, Suite 305, Framingham, MA 01702, USA
^e Department of Psychiatry, Massachusetts General Hospital, 15 Parkman, Boston, MA 02114, USA

Corresponding author. Department of Psychiatry, Massachusetts General Hospital, ACC 812, 15 Parkman Street, Boston, MA 02114.

Résumé

Although changes in the US health care system promote a population-based approach, increases in population diversity emphasize the need for culturally competent, patient-centered, participatory care. Despite this perceived conflict, the global view has improved the recognition of mental health issues as a driver of overall health as well as health care spending. This recognition, along with the many forces that keep mental health care in the primary care sector, actually encourages the development of collaborative models that capitalize on the primary care provider’s opportunity to leverage their rapport with the patient to improve access to, and comfort with, specialty mental health services. Engaging patients in their own path to recovery or well-being improves engagement in, and adherence to, the treatment plan and ultimately improves outcomes.

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Keywords : Collaborative care, Cultural competence, Rapport, Adherence, Primary care, Consultation psychiatry