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Journal of Clinical Psychology in Medical Settings

Published in:

01-03-2012

Implementation of Primary Care-Mental Health Integration Services in the Veterans Health Administration: Program Activity and Associations with Engagement in Specialty Mental Health Services

Authors: Laura O. Wray, Benjamin R. Szymanski, Lisa K. Kearney, John F. McCarthy

Published in: Journal of Clinical Psychology in Medical Settings | Issue 1/2012

Abstract

This paper describes the status of the Veterans Health Administration (VHA) Primary Care-Mental Health Integration (PC-MHI) services implementation and presents an assessment of associations between receipt of PC-MHI services and likelihood of receiving a second specialty mental health (SMH) appointment following an initial SMH encounter. The total PC-MHI service recipients and encounters/month rose substantially between October 2007 and April 2011. Adjusting for important covariates, the likelihood of receiving a second SMH encounter within 3 months of an index SMH appointment was 1.37 times greater among individuals who had received a PC-MHI encounter within 3 months of the initial SMH appointment. Implementation of VHA PC-MHI services has substantially increased VHA capacity to deliver mental health services in primary care and findings indicate that PC-MHI services are associated with greater engagement in SMH treatment. Implementation of VHA PC-MHI services is progressing with new technical assistance strategies being deployed.

Anstiss, T. (2009). Motivational interviewing in primary care. Journal of Clinical Psychology in Medical Settings, 16, 87–93.PubMedCrossRef

Bartels, S. J., Coakley, E. H., Zubritsky, C., Ware, J. H., Miles, K. M., Arean, P. A., et al. (2004). Improving access to geriatric mental health services: A randomized trial comparing treatment engagement with integrated versus enhanced referral care for depression, anxiety, and at-risk alcohol use. American Journal of Psychiatry, 161, 1455–1462.PubMedCrossRef

Brawer, P. A., Martielli, R., Pye, P. L., Manwaring, J., & Tierney, A. (2010). St. Louis Initiative for Integrated Care Excellence (SLI²CE): Integrated-Collaborative care on a large scale model. Families, Systems and Health, 28, 175–187.CrossRef

Brockmann, L., & McCarthy, J. (2011). National VHA Primary Care-Mental Health Integration Program implementation: Findings from the 2010 PC-MHI evaluation survey. Paper presented at Improving Veterans Mental Health Care for the 21^st Century. Baltimore, MD: The VA National Mental Health conference.

Bush, D. E., Ziegeldtein, R. C., Patel, U. V., Thombs, B. D., Ford, D. E., Fauerbach, J. A., et al. (2005). Post-myocardial infarction depression. Summary. AHRQ publication Number 05–E018-1. Evidence Report/Technology Assessment Number 123. Rockville, MD: Agency for Healthcare Research and Quality.

Butler, M., Kane, R. L., McAlpine, D., Kathol, R. G., Fu, S. S., Hagedorn, H., et al. (2008). Integration of mental health/substance abuse and primary care. AHRQ Publication Number 09–E003. Evidence Report/Technology Assessment, Number 173. Rockville, MD: Agency for Healthcare Research and Quality.

Chen, H., Coakley, E. H., Cheal, K., Maxwell, J., Costantino, G., Krahn, D. D., et al. (2006). Satisfaction with mental health services in older primary care patients. American Journal of Geriatric Psychiatry, 14, 371–379.PubMedCrossRef

Department of Veterans Affairs. (2008). Uniform mental health services in VA medical centers and clinics. VHA handbook 1600.01. Washington, DC: Department of Veterans Affairs.

Funderburk, J. S., Sugarman, D. E., Maisto, S. A., Ouimette, P., Schohn, M., Lantinga, L., et al. (2010). The description and evaluation of the implementation of an integrated healthcare model. Families, Systems and Health, 28, 146–160.CrossRef

Gilbody, S., Bower, P., Fletcher, J., Richards, D., & Sutton, A. J. (2006). Collaborative care for depression: A cumulative meta-analysis and review of longer-term outcomes. Archives of Internal Medicine, 166, 2314–2321.PubMedCrossRef

Graham, I. D., & Tetroe, J. (2009). Learning from the US Department of Veterans Affairs Quality Enhancement Research Initiative: QUERI series. Implementation Science, 4, 1–6.CrossRef

Hedrick, S. C., Chaney, E. F., Felker, B., Liu, C.-F., Hasenberg, N., Heagerty, P., et al. (2003). Effectiveness of collaborative care depression treatment in Veterans’ Affairs primary care. Journal of General Internal Medicine, 18, 9–16.PubMedCrossRef

Hunkeler, E. M., Katon, W., Tang, L., Williams, J. W., Kroenke, K., Lin, E. H. B., et al. (2006). Long term outcomes from the IMPACT randomized trial for depressed elderly patients in primary care. British Medical Journal (Clinical research ed.), 332, 259–263.CrossRef

Hunter, C. L., Goodie, J. L., Oordt, M. S., & Dobmeyer, A. C. (2009). Integrated behavioral health in primary care: Step-by-step guidance for assessment and intervention. Washington, DC: American Psychological Association.CrossRef

Insel, T. R. (2008). Assessing the economic costs of serious mental illness. American Journal of Psychiatry, 165, 663–665.PubMedCrossRef

Institute of Medicine. (2001). Crossing the quality chasm: A new health system for the 21 ^st century. Washington, DC: National Academies Press.

Karlin, B. E., & Fuller, J. D. (2007). Geriatric mental health service use and treatment outcomes: Implications for primary care practice. Geriatrics, 62, 26–35.PubMed

Katon, W., Von Korff, M., Lin, E., Walker, E., Simon, G. E., Bush, T., et al. (1995). Collaborative management to achieve treatment guidelines. Impact on depression in primary care. JAMA, 273, 1026–1031.PubMedCrossRef

Krahn, D. D., Bartels, S. J., Coakley, E., Oslin, D. W., Chen, H., Mclntyre, J., et al. (2006). PRISM-E: Comparison of integrated care and enhanced specialty referral models in depression outcomes. Psychiatric Services, 57, 946–953.PubMedCrossRef

Longman, P. (2007). Best care anywhere: Why VA health care is better than yours. Sausalito: Polipoint Press.

Lui, C. F., Cedrick, S. C., Chaney, E. F., Heagerty, P., Felker, B., Hasenberg, N., et al. (2003). Cost effectiveness of collaborative care for depression in primary care veteran population. Psychiatric Services, 54, 698–704.CrossRef

Murray, C. L., & Lopez, A. D. (1996). The global burden of disease: A comprehensive assessment of mortality and disability from diseases, injuries, and risk factors in 1990 and projected to 2020. Harvard School of Public Health; World Health Organization; World Bank. Cambridge, MA: Harvard University Press.

Oslin, D. W., Grantham, S., Coakley, E., Maxwell, J., Miles, K., Ware, J., et al. (2006). PRISM-E: Comparison of integrated care and enhanced specialty referral in managing at-risk alcohol use. Psychiatric Services, 57, 954–958.PubMedCrossRef

Oslin, D. W., Ross, J., Sayers, S., Murphy, J., Kane, V., & Katz, I. R. (2006). Screening, assessment, and management of depression in VA primary care clinics: The behavioral health laboratory. Journal of General Internal Medicine, 21, 46–50.PubMedCrossRef

Oslin, D. W., Sayers, S., Ross, J., Kane, V., Have, T., Conigliaro, J., et al. (2003). Disease management for depression and at-risk drinking via telephone in an older population of Veterans. Psychosomatic Medicine, 65, 931–937.PubMedCrossRef

Pfeiffer, P. N., Szymanski, B. R., Zivin, K., Post, E. P., Valenstein, M., & McCarthy, J. F. (2011). Are primary care mental health services associated with differences in specialty mental health clinic use? Psychiatric Services, 62, 422–425.PubMedCrossRef

Pincus, H. A., Spaeth-Rublee, B., & Watkins, K. E. (2011). The case for measuring quality in mental health and substance abuse care. Health Affairs, 30, 730–736.PubMedCrossRef

Pomerantz, A., Cole, B. H., Watts, B. V., & Weeks, W. B. (2008). Improving efficiency and access to mental health care: Combining integrated care and advanced access. General Hospital Psychiatry, 30, 546–551.PubMedCrossRef

Regier, D. A., Narrow, W. E., Rae, D. S., Manderscheid, R. W., Locke, B. Z., & Goodwin, F. K. (1993). The de facto US mental and addictive disorders service system. Epidemiological catchment area prospective 1-year rates of disorders and services. Archives of General Psychiatry, 50, 85–94.PubMedCrossRef

Rollnick, S., & Miller, W. R. (2002). Motivational interviewing: Preparing people for change (2nd ed.). New York: Guilford Publications, Inc.

Rollnick, S., Miller, W. R., & Butler, C. C. (2007). Motivational interviewing in health care: Helping patients change behavior. New York: Guilford Publications, Inc.

Simon, G. E., Ormel, J., Von Korff, M., & Barlow, W. (1995). Health care costs associated with depressive and anxiety disorder in primary care. American Journal of Psychiatry, 152, 352–357.PubMed

Simpson, D. D., & Joe, G. W. (2004). A longitudinal evaluation of treatment engagement and recovery stages. Journal of Substance Abuse Treatment, 27, 89–97.PubMedCrossRef

Speer, D. C., & Schneider, M. G. (2003). Mental health needs of older adults and primary care: Opportunity for interdisciplinary geriatric team practice. Clinical Psychology: Science and Practice, 10, 85–101.CrossRef

Strosahl, K., Baker, N. J., Braddick, M., Stuart, M. E., & Handley, M. R. (1997). Integration of behavioral health and primary care services: The group health cooperative model. In N. A. Cummings, J. L. Cummings, & J. N. Johnson (Eds.), Behavioral health in primary care: A guide for clinical integration (pp. 61–86). Madison, CT US: Psychosocial Press.

Unützer, J., Katon, W., Callahan, C. M., Williams, J. W., Hunkeler, E., Harpole, L., et al. (2002). Collaborative care management of late-life depression in the primary care setting: A randomized controlled trial. JAMA, 288, 2836–2845.PubMedCrossRef

Wells, K. B., Stewart, A., Hays, R. D., Burnam, M. A., Rogers, W., Daniels, M., et al. (1989). The functioning and well-being of depressed patients: Results from the medical outcomes study. JAMA, 262, 914–919.PubMedCrossRef

Williams, J. W., Gerrity, M., Holsinger, T., Dobscha, S., Gaynes, B., & Dietrich, A. (2007). Systematic review of multifaceted interventions to improve depression care. General Hospital Psychiatry, 29, 91–116.PubMedCrossRef

Zanjani, F., Miller, B., Turiano, N., Ross, J., & Oslin, D. (2008). Effectiveness of telephone-based referral care management, a brief intervention to improve psychiatric treatment engagement. Psychiatric Services, 59, 776–781.PubMedCrossRef

Zeiss, A. M., & Karlin, B. E. (2008). Integrating mental health and primary care services in the Department of Veterans Affairs health care system. Journal of Clinical Psychology in Medical Settings, 15, 73–78.PubMedCrossRef

Zivin, K., Pfeiffer, P. N., Szymanski, B. R., Valenstein, M., Post, E. P., Miller, E. M., et al. (2010). Initiation of primary care-mental health integration programs in the VA health system: associations with psychiatric diagnoses in primary care. Medical Care, 48, 843–851.PubMedCrossRef

Title: Implementation of Primary Care-Mental Health Integration Services in the Veterans Health Administration: Program Activity and Associations with Engagement in Specialty Mental Health Services
Authors: Laura O. Wray
Benjamin R. Szymanski
Lisa K. Kearney
John F. McCarthy
Publication date: 01-03-2012
Publisher: Springer US
Published in: Journal of Clinical Psychology in Medical Settings / Issue 1/2012
Print ISSN: 1068-9583
Electronic ISSN: 1573-3572
DOI: https://doi.org/10.1007/s10880-011-9285-9

Keynote webinar | Spotlight on medication adherence

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Implementation of Primary Care-Mental Health Integration Services in the Veterans Health Administration: Program Activity and Associations with Engagement in Specialty Mental Health Services

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

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