The Effects of Primary Care Behavioral Health in Primary Care in Sweden

Psychosocial and mental health problems is a growing public health concern and challenge for primary care where resources are scarce. The multi-professional novel service delivery model "Primary Care Behavioural Health" (PCBH) has been suggested as an effective way to integrate behavioural health services into routine primary care. The model offer high accessibility to brief interventions, is clinically intuitively attractive and has been disseminated in primary care organizations globally, as well as in Sweden. However, more research is needed on its effect and implementation in routine care. The objective is to investigate the effect of the new service delivery model PCBH on organization- staff- and patient outcomes, and to investigate the implementation of PCBH in terms of how and to which degree the new way of working is normalised in practice routines. This multicenter mixed-methods interventional study is designed as a controlled pragmatic clinical trial. The effect of PCBH will be investigated on organizational, staff and patient levels. Variables include waiting lists, symptoms, medication prescriptions, quality of life and working environment aspects. Study participants will be patients, staff and managers at the included primary care centers. Implementation of PCBH will be investigated regarding the implementation process and degree of implementation. Data will be both qualitative (individual interviews) and quantitative (registers, biomarkers and questionnaires). At least 24 intervention centers will be compared to an equal number of control centers. The research project will be conducted in several regions in Sweden during a period of 4 years. PCBH seems to offer a solution the challenges in modern primary care, but evidence is low. This study will provide much-needed clinically meaningful data regarding PCBH that hopefully could be used for future development of primary healthcare.

• Accessibility at the health care center, measured in waiting times. [Срок оценки: In total 3 years: one year before baseline (baseline: when implementation starts), thereafter during 2 year from baseline.]
• Quality of life of the patients. [Срок оценки: 2 years from baseline (first visit to a health care professional due to a mental health issue, therafter after 6, 12 and 24 months).]
• Symptoms of anxiety in the patients. [Срок оценки: 2 years from baseline (first visit to a health care professional due to a mental health issue, therafter after 6, 12 and 24 months).]
• Symptoms of depression in the patients [Срок оценки: 2 years from baseline (first visit to a health care professional due to a mental health issue, therafter after 6, 12 and 24 months).]
• Referrals to psychiatric care [Срок оценки: In total 3 years: one year before baseline (baseline: when implementation starts), thereafter during 2 year from baseline.]
• Work commitment among the medical staff [Срок оценки: 2 years in total: at baseline, therafter at 6, 12 and 24 months.]
• Exhaustion among the medical staff [Срок оценки: 2 years in total: at baseline, therafter at 6, 12 and 24 months.]
• Fidelity to the core components among the medical staff [Срок оценки: 2 years in total: at baseline, therafter at 6, 12 and 24 months.]
• Medical treatment of patients due to mental health issues [Срок оценки: In total 3 years: one year before baseline (baseline: when implementation starts), thereafter during 2 year from baseline.]
• Sick leave of patients due to mental health issues [Срок оценки: In total 3 years: one year before baseline (baseline: when implementation starts), thereafter during 2 year from baseline.]