The Spectrum of Integrated Care
Over the years many professionals in the field of psychology, psychiatry, social work, and medicine have struggled to
efficiently and systematically practice an integrated approach to treating patients with mental disorders. These
difficulties may stem from different clinical cultures among professionals, fragmented delivery systems, and a lack of
coordination within the treatment team. The Department of Health (1984) recommended that the development and
establishment of multidisciplinary teams would be required to cater adequately to the needs of the mentally ill in the
community. This innovative idea has shaped the current structure of working with individuals living with mental
disorders...not only treating the individual diagnosis, but also taking a person-centered approach.
The central aim of the Integrated Treatment Approach is to provide mental health care from a multidisciplinary team
where: (1) the needs of the individual are identified and responded to accordingly (2) individuals are encouraged to be
active participants in the treatment planning process (3} and care is planned, collaborative, and coordinated on a
consistent basis.
According to Tyrer (1998) research evidence supports" the multidisciplinary team" as the most effective means of
delivering a comprehensive mental health treatment approach. As we begin to breakdown how multidisciptinary teams
work together we are directed towards the systematic approach of Integrated Care. While collaborative care can be
defined as professionals who work WITH each other for the overall success of an individual, integrated care emphasizes
the idea that professionals work WITHIN and AS PART OF the overall treatment team and supportive network.
There are several distinguishing concepts common to the Integrated Treatment Model, which include:
- Central Location: centralized administrative location, adoption of evidence-based and emerging treatment
guidelines, patient tracking systems, team collaboration systems, etc.
- Treatment Team: development of team/patient relationship instead of doctor/patient relationship, treatment
team members educate each other about disciplines and approaches, members of treatment team share
responsibility for care, some visits are choreographed to include physician, case coordinator, and additional
specialists.
- Stepped Care: depending on patient baseline functioning and their stage of recovery the intensity of
treatment is customized
COORDINATED
- Stepped Care
- Clinicians and services are located at different sites
- Each individual clinician has separate treatment plans
- Routine exchanges of info between separate treatment providers
CO-LOCATED
- Stepped Care
- Central Location:Service specialties located in the same facility
- Enhanced formal and informal communication (face-to-face, phone)
- Consultations between differing specialists
INTEGRATED
- Stepped Care
- Central Location:Service specialties and physicians located within CNS
- All services are guided by the same treatment guidelines, systems, and principles of CNS
- Treatment Team
- One treatment plan between all specialists for one patient
- Treatment is overseen by a Case Coordinator
- Use of database by all treatment team clinicians to track patient progress
- Internal Treatment Team Meetings and Appointments