How effective are different service linkage strategies in primary mental health care?

Aims & rationale/Objectives: Linkages between primary care, mental health and other services are key components of Australian policies to meet mental health needs. Linking services can be difficult, and requires scarce resources which should be directed to models with proven strategies. This research aimed to assess the research evidence for service linkages in primary mental health care and examine its applicability in the Australian context. Methods: A narrative systematic review of international scientific literature and key informant interviews was informed by an expert reference group. The analysis examined the implications of the findings for Australian policies and services. Principal findings: Data extracted from 42 studies showed measurable effects on patients\u27 clinical condition and organisational outcomes from multi-component linkage strategies between primary and specialist care for high prevalence disorders. Strategies included: collaborative care processes and structures, care guidelines; and enhanced communication systems. There was no evidence supporting single component strategies. There was little evidence about linked services for serious mental illness and virtually none about linkages with wider human services outside health. Implications: Most mental health care is provided in the community by primary care practitioners. If they are to achieve the best outcomes for patients and organisations they need effective linkages with specialist and human service providers. This paper will describe how such linkages might be developed in the Australian context