Integrating Bipolar Disorder Management in Primary Care

• Published in: Current psychiatry reports Vol. 14; no. 6; pp. 687 - 695
• Main Authors: Kilbourne, Amy M., Goodrich, David E., O’Donnell, Allison N., Miller, Christopher J.
• Format: Journal Article
• Language: English
• Published: New York Current Science Inc 01-12-2012; Springer Nature B.V
• Subjects: Bipolar disorder; Bipolar Disorder - diagnosis; Bipolar Disorder - epidemiology; Bipolar Disorder - therapy; Bipolar Disorders (MA Frye; Chronic Disease - therapy; Cost of Illness; Health Services Accessibility; Health Services Needs and Demand - economics; Health Services Needs and Demand - organization & administration; Humans; Medicine; Medicine & Public Health; Mental health; Mental Health Services - economics; Mental Health Services - organization & administration; Practice Guidelines as Topic; Primary care; Primary Health Care - economics; Primary Health Care - organization & administration; Psychiatry; Section Editor; United States - epidemiology; United States; Mood disorder; Co-occurring conditions; Collaborative care; Access; Bipolar disorder; CCM; Primary care; Screening; Integrated care; Treatment; Mental health services; Diagnosis; Chronic Care Model; Psychiatry
• ISSN: 1523-3812; 1535-1645
• DOI: 10.1007/s11920-012-0325-4

There is growing realization that persons with bipolar disorder may exclusively be seen in primary (general medical) care settings, notably because of limited access to mental health care and stigma in seeking mental health treatment. At least two clinical practice guidelines for bipolar disorder recommend collaborative chronic care models (CCMs) to help integrate mental health care to better manage this illness. CCMs, which include provider guideline support, self-management support, care management, and measurement-based care, are well-established in primary care settings, and may help primary care practitioners manage bipolar disorder. However, further research is required to adapt CCMs to support complexities in diagnosing persons with bipolar disorder, and integrate decision-making processes regarding medication safety and tolerability in primary care. Additional implementation studies are also needed to adapt CCMs for persons with bipolar disorder in primary care, especially those seen in smaller practices with limited infrastructure and access to mental health care.