Date of Award

Spring 2024

Project Type

Clinical Doctorate

College or School




Program or Major

Doctor of Nursing

Degree Name


First Advisor

Cathleen Colleran


Primary care, an extensive of family medicine remains a key access point for patients entering the healthcare system. Accessing medical care and specialty psychiatric services is limited in rural communities. Patients often find exhaustive wait times, untimely referrals, and reliance on emergency services for crisis management. The primary care provider is able to help their community improve access to behavioral health care by using a collaborative approach. This quality improvement initiative used the framework produced by the AIMS Center at the University of Washington and adopted for use creating an 8-week intensive program in a family medical practice located in a medically underserved area in New Hampshire. This collaborative care model served nine participants. The results of this collaborative care model reflect the efficacy of using this integrated care models in primary care and support accessibility to specialty care. Participants reported improved symptoms of anxiety and depression and increased resiliency. Interventions optimized medical management for chronic health conditions including medication use and management, cognitive behavioral therapy and lifestyle modifications. Reported symptoms of depression, anxiety, and degree of resiliency to cope with stress by average score were tracked and used for analysis of patient outcomes. The results represent increased accessibility to specialty psychiatric care in less time than the national average, improved quality of life and psychological and medical stability.

Keywords: primary care, collaborative care, rural health, depression, anxiety, resilience