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Integrating Mental Health Services Within Primary Care Settings: The Hamilton Family Health Team

Kates, Nick MBBS, FRCPC, MCFP (Hon); McPherson-Doe, Catherine MSW; George, Lindsey MD, FRCPC

Journal of Ambulatory Care Management: April/June 2011 - Volume 34 - Issue 2 - p 174–182
doi: 10.1097/JAC.0b013e31820f6435

For 16 years, the Hamilton Family Health Team Mental Health Program has successfully integrated mental health counselors, addiction specialists, child mental health professionals, and psychiatrists into 81 offices of 150 family physicians in Hamilton, Ontario. Maximising the potential of a “shared care” model requires changes within the primary care setting, to support the addition of mental health and addiction professionals, active involvement of primary care staff in managing mental health problems of patients, and collaborative practice. This coordinated effort allow mental health treatment through onsite support from a mental health team and supplants the need to refer most patients to the mental health setting. This article reviews the evolution of the program and the changes made by practices with key lessons learnt.

Author Affiliations: Hamilton Family Health team (Drs Kates and George, Ms McPherson-Doe); Department of Psychiatry and Behavioural Neurosciences, McMaster University (Drs Kates and George), Hamilton, Ontario, Canada.

This work was supported by Ontario Ministry of Health and Long Term Care.

Correspondence: Nick Kates, MBBS, FRCPC, MCFP (Hon), c/o Hamilton FHT, 10 George St., 3rd floor, Hamilton, ON L8P 1C8, Canada (

© 2011 Lippincott Williams & Wilkins, Inc.