IMPLEMENTING A PRIMARY CARE BEHAVIORAL HEALTH SERVICE DELIVERY MODEL FOR MENTAL HEALTH PRACTICE: A PRAGMATIC CLUSTER TRIAL (STEPPED WEDGE)

Mental health problems represent a large and growing public health concern.

Primary care handles most of the patients with mental health problems, but there are many barriers to detection and treatment in this setting, causing under-recognition and under-treatment of patients.

The service delivery model Primary Care Behavioral Health (PCBH) shows promise to manage mental health problems in primary care, but more research is needed regarding its effects on multiple levels.

This project investigates the effectiveness and implementation of a large-scale implementation of PCBH in one region in Sweden.

The aim is to generate new knowledge concerning the impact of a real-world implementation and use of PCBH in routine primary care. Results will be investigated at patient, staff and organization levels.

A Pragmatic Stepped-Wedge Cluster Trial will be used: 24 PCBH primary care centres in one region will be compared with 48 standard care centres in three other regions. The model will be implemented sequentially at the PCBH centres according to a staggered timetable. Preliminary analyses of 4 pilot PCBH centres suggest feasibility and promising results of the model.

The project will be led by professor Per Nilsen, Linköping University, who has assembled a highly qualified interdisciplinary and interprofessional team with expertise in mental health, primary care, implementation science, multi-centre studies, clinical research, pragmatic trials, statistics and health economics.