Date of Award

Spring 2024

Project Type

Clinical Doctorate

College or School

CHHS

Department

Nursing

Program or Major

Doctor of Nursing Practice

Degree Name

Other

First Advisor

Cathleen Colleran

Second Advisor

Dennis Badman

Third Advisor

Lydia McKenzie

Abstract

Primary care, an extension of family medicine remains a key access point for patients entering the healthcare system. Accessing specialty psychiatric services can be limited in rural communities due to provider shortages and geographical constraints. Primary care providers can facilitate improved access to behavioral health services by introducing a collaborative approach to the traditional medical model. This quality improvement initiative adopted the collaborative care model originally produced by the University of Washington to treat common mental health conditions in the medical setting (2023). A team consisting of a primary care provider, behavioral health case manager and psychiatric consultant served nine participants residing in a rural, medically underserved area in New Hampshire. Interventions optimized medical management for chronic health conditions and addressed behavioral health needs with evidence-based interventions, cognitive behavioral therapy, and motivational interviewing. Self-reported symptoms of depression, anxiety, and degree of resiliency by average score were tracked and used for analysis of patient outcomes. Overall, participants reported improved symptoms of depression and anxiety and increased resiliency and ability to cope with stress. The results revealed increased accessibility to specialty psychiatric care in less time than the national average, improved quality of life and psychological and medical stability for participants.

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