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247 APPENDIX A INSTITUTE OF MEDICINE An Invitational Conference: The Provision of Mental Health Services in Primary Care Settings National Academy of Sciences Washington, D.C. April 2-3, 1979 AGENDA Monday, April 2 2101 Constitution Avenue, N.W National Academy of Sciences Lecture Room 8:00 a.m. 8:45 a.m. 9:00 a.m. 9:15 a.m. 9:20 a.m. 9:45 a.m Registration Welcome David A. Hamburg, M.D. President, Institute of Medicine Opening Remarks Herbert Pardes, M.D. Director, National Institute of Mental Health Merle Cunningham, M.D. Bureau of Community Health Services Health Services Administration Policy Issues on Provision of Mental Health Services in Primary Care Settings A Federal View Gerald L. Klerman, M.D. Administrator, Alcohol, Drug Abuse and Mental Health Administration Discussion

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248 10:00 a.m. 10:15 arm. 10:35 a.m. 10:45 a.m. 11:45 a.m. 12:15 p.m. 1:15 p.m. Coffee Break Nature and Scope of Mental Health Problems in Primary Care Darrel Regier, M.D. Division of Biometry and Epidemiology National Institute of Mental Health Questions Delivering Mental Health Services in Primary Care Settings: Some Successful Models Chairman: Jonathan Borus, M.D. Massachusetts General Hospital Neighborhood Health Center Model Barbara Burns, Ph.D. Primary Care Research Section Applied Biometrics Research Branch, NIMH Mental Health in a Fee-for-Service Pediatric Practice Lawrence Pakula, M.D. Timonium, Maryland Treatment of Emotional Problems by Primary Physicians in an HMO Jules Coleman, M.D. Community Health Center Plan New Haven, Connecticut Discussion Lunch -- NAS Refectory Identification and Management of Mental Health Problems in Primary Care Settings Chain: David A. Hamburg, M.D. Training of Family Physicians in Mental Health Skills: Implications of Recent Research David Goldberg, M.D. University of Manchester England

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249 Observations on the Impact of Psychiatric Disorder upon Primary Medical Care Edwin Hoeper, M.D. Marshfield Clinic Marshfield, Wisconsin Literature Review on Management of Emotionally Disturbed Patients in Primary Care Settings Janet Hankin, Ph.D. Johns Hopkins Health Services Research and Development Center Suicide Prevention by Family Physicians Opportunities and Limitations Thomas Madden, M.D. Department of Preventive Medicine Rush-Presbyterian -- St.Lukes Medical Center Chicago, Illinois 2:30 p.m. 3:00 p.m. 3:15 p.m. Discussion Coffee Break Issues in Training, Organizational Structure and Financing Chairman: Steven Sharfstein, M.D. Division of Mental Health Service Programs National Institute of Mental Health The Primary Care Physician: Robert Lawrence, M.D. Harvard Medical School Mental Health Skills The Role of the Psychiatrist in the Primary Care Setting: Issues and Problems Alan Jacobson, M.D. Joslin Clinic Boston, Massachusetts Reimbursement for Mental Health Services in Primary Care Settings Alexander Richman, M.D. in collaboration with Murray G. Brown, Ph.D. and Vernon Hicks, M.D. Dalhousie University Halifax, Nova Scotia

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250 Problems in Analyzing the Cost-Offset in Providing Mental Health Services in Primary Care Settings Herbert Schlesinger, Ph.D. in collaboration Emily Mumford, Ph.D. and Gene V. Glass, Ph.D. University of Colorado Medical School Denver, Colorado 4:40 p.m 5:00 p.m. - 7:00 p.m. Tuesday, Anri 1 8:30 a.m. 9:30 a.m. 12:30 p.m. 1:30 p.m. 2:00 p.m. Discussion Reception -- Great Hall Plenary Session -- Lecture Room Introductory Remarks -- David A. Hamburg, M.D. Mental Health as an Integrant of Primary Care Michael Shepherd, M.D. Professor of Epidemiological Psychiatry Institute of Psychiatry University of London Workshops Group A Chair: A. Alan Fischer, M.D. Rapporteur: Fredric Solomon, M.D. Group B Chair: Lisbeth Schorr Rapporteur: William Lybrand, Ph.D. Group C Chair: Barbara Starfield, M.D. Rapporteur: Elena Nightingale, M.D. Lunch -- NAS Refectory Workshop Summaries __ Lecture Room Panel: Future Directions in Coordination of Mental Health Services and Primary Care Julius Richmond, M.D. Assistant Secretary for Health Department of Health, Education and Welfare Gerald Klerman, M.D. Administrator, Alcohol, Drug Abuse and Mental Health Administration, DREW

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251 George Lythcott, M. D. Admini s tra tar Health Services Administration, DHEW 3:00 p.m. 3:30 p.m. Di sc us s ion -- Final Remarks Adjourn

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