Table 1

Linkage strategies in primary mental health care

Direct collaborative activitiesLink workingOrganisational tasks connecting 2+ services—may involve limited clinical intervention but not expert clinical advice or structured liaison
Co-locationFace to face—location of mental health worker in primary care—must provide treatment in primary care
Consultation liaisonPerson 1 provides advice about care to person 2 without transfer of care—can be via a link worker
Care managementCoordination of care—including assessment, review, follow-up and care management plan; linking with other services or defined care pathway
Agreed guidelinesProtocolsAgreed treatment algorithm—pharmacotherapy or psychological therapy
Stepped careTreatment escalation or de-escalation procedure to other providers
Communication systemsEnhanced communicationFormal process with feedback—meetings, shared medical record
Enhanced referralExpedited access—explicit referral criteria/ process.
Electronic communication systemTele—video conference connecting 2+ services
Service agreementService agreementMemorandum of understanding—formal contract/ funding mechanism about how services work together