Skip to main content
Top
Published in: Journal of Clinical Psychology in Medical Settings 1/2008

01-03-2008

Integrating Mental Health and Primary Care Services in the Department of Veterans Affairs Health Care System

Authors: Antonette M. Zeiss, Bradley E. Karlin

Published in: Journal of Clinical Psychology in Medical Settings | Issue 1/2008

Login to get access

Abstract

Integrating mental health care in the primary care setting has been identified in the literature as a model for increasing access to mental health services and has been associated with enhanced clinical and functional patient outcomes and higher patient satisfaction. The Department of Veterans Affairs (VA), which operates the nation’s largest integrated health care system, has taken a leadership role in creating a health care system in which mental health care is provided in the primary care setting. This article examines VA’s efforts and progress to date in implementing evidence-based models of integrated mental health services nationally in community based outpatient clinics, home based primary care, and outpatient primary clinics at medical facilities. Psychology plays an important role in this progress, as part of an overall interdisciplinary effort, in which all professions are crucially important and work together to promote the overall well-being of patients.
Literature
go back to reference Areán, P. A., Alvidrez, J., Barrera, A., Robinson, G. S., & Hicks, S. (2002). Would older medical patients use psychological services? Gerontologist, 42, 392–398.PubMed Areán, P. A., Alvidrez, J., Barrera, A., Robinson, G. S., & Hicks, S. (2002). Would older medical patients use psychological services? Gerontologist, 42, 392–398.PubMed
go back to reference Bartels, S. J., Coakley, E. H., Zubritsky, C., Ware, J. H., Miles, K. M., Areán, 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 Bartels, S. J., Coakley, E. H., Zubritsky, C., Ware, J. H., Miles, K. M., Areán, 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
go back to reference 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 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
go back to reference Felker, B. L., Chaney, E., Rubenstein, L. V., Bonner, L. M., Yano, E. M., Parker, L. E., et al. (2006). Developing effective collaboration between primary care and mental health providers. Primary Care Companion to the Journal of Clinical Psychiatry, 8, 12–16.PubMed Felker, B. L., Chaney, E., Rubenstein, L. V., Bonner, L. M., Yano, E. M., Parker, L. E., et al. (2006). Developing effective collaboration between primary care and mental health providers. Primary Care Companion to the Journal of Clinical Psychiatry, 8, 12–16.PubMed
go back to reference Hedrick, S. C., Chaney, E. F., Felker, B., Liu, C., Hasenberg, N., Heagerty, P., et al. (2003). Effectiveness of collaborative care depression treatment in Veterans’ Affairs primary care. Journal of Internal Medicine, 18, 9–16. Hedrick, S. C., Chaney, E. F., Felker, B., Liu, C., Hasenberg, N., Heagerty, P., et al. (2003). Effectiveness of collaborative care depression treatment in Veterans’ Affairs primary care. Journal of Internal Medicine, 18, 9–16.
go back to reference 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 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
go back to reference Katon, W., Von Korff, M., Lin, E., Simon, G., Walker, E., Unutzer, J., et al. (1999). Stepped collaborative care for primary care patients with persistent symptoms of depression: A randomized trial. Archives of General Psychiatry, 56, 1109–1115.PubMedCrossRef Katon, W., Von Korff, M., Lin, E., Simon, G., Walker, E., Unutzer, J., et al. (1999). Stepped collaborative care for primary care patients with persistent symptoms of depression: A randomized trial. Archives of General Psychiatry, 56, 1109–1115.PubMedCrossRef
go back to reference Katon, W., Russo, J., Von Korff, M., Lin, E., Simon, G., Bush, T., et al. (2002). Long-term effects of a collaborative care intervention in persistently depressed primary care patients. Journal of Geriatric Internal Medicine, 17, 741–748.CrossRef Katon, W., Russo, J., Von Korff, M., Lin, E., Simon, G., Bush, T., et al. (2002). Long-term effects of a collaborative care intervention in persistently depressed primary care patients. Journal of Geriatric Internal Medicine, 17, 741–748.CrossRef
go back to reference Longman, P. (2007). Best care anywhere: Why VA health care is better than yours. Sausalito: PoliPoint Press. Longman, P. (2007). Best care anywhere: Why VA health care is better than yours. Sausalito: PoliPoint Press.
go back to reference Liu, 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 a primary care veteran population. Psychiatric Services, 54, 698–704.PubMedCrossRef Liu, 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 a primary care veteran population. Psychiatric Services, 54, 698–704.PubMedCrossRef
go back to reference 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., 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
go back to reference Pignone, M. P., Gaynes, B. N., Rushton, J. L., Burchell, C. M., Orleans, C. T., Mulrow, C. D., et al. (2002). Screening for depression in adults: A summary of the evidence for the U.S. Preventive Services Task Force. Annals of Internal Medicine, 136, 765–76.PubMed Pignone, M. P., Gaynes, B. N., Rushton, J. L., Burchell, C. M., Orleans, C. T., Mulrow, C. D., et al. (2002). Screening for depression in adults: A summary of the evidence for the U.S. Preventive Services Task Force. Annals of Internal Medicine, 136, 765–76.PubMed
go back to reference Rollman, B. L., Belnap, B. H., Mazumdar, S., Houck, P. R., Zhu, F., Gardner, W., et al. (2005). A randomized trial to improve the quality of treatment for panic and generalized anxiety disorders in primary care. Archives of General Psychiatry, 62, 1332–1341.PubMedCrossRef Rollman, B. L., Belnap, B. H., Mazumdar, S., Houck, P. R., Zhu, F., Gardner, W., et al. (2005). A randomized trial to improve the quality of treatment for panic and generalized anxiety disorders in primary care. Archives of General Psychiatry, 62, 1332–1341.PubMedCrossRef
go back to reference Roy-Byrne, P. B., Katon, W., Cowley, D. S., & Russo, J. (2001). A randomized effectiveness trial of collaborative care for patients with panic disorder in primary care. Archives of General Psychiatry, 58, 869–876.PubMedCrossRef Roy-Byrne, P. B., Katon, W., Cowley, D. S., & Russo, J. (2001). A randomized effectiveness trial of collaborative care for patients with panic disorder in primary care. Archives of General Psychiatry, 58, 869–876.PubMedCrossRef
go back to reference Skultety, K. M., & Zeiss, A. M. (2006). The treatment of depression in older adults in the primary care setting: An evidence-based review. Health Psychology, 25, 665–674.PubMedCrossRef Skultety, K. M., & Zeiss, A. M. (2006). The treatment of depression in older adults in the primary care setting: An evidence-based review. Health Psychology, 25, 665–674.PubMedCrossRef
go back to reference 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, 21, 85–101.CrossRef 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, 21, 85–101.CrossRef
go back to reference Tai-Seale, M., Bramson, R., Drukker, D., Hurwicz, M. L., Ory, M., Tai-Seale, T., et al. (2005). Understanding primary care physicians’ propensity to assess elderly patients for depression using interaction and survey data. Medical Care, 43, 1217–1224.PubMedCrossRef Tai-Seale, M., Bramson, R., Drukker, D., Hurwicz, M. L., Ory, M., Tai-Seale, T., et al. (2005). Understanding primary care physicians’ propensity to assess elderly patients for depression using interaction and survey data. Medical Care, 43, 1217–1224.PubMedCrossRef
go back to reference 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. Journal of the American Medical Association, 288, 2836–2845.PubMedCrossRef 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. Journal of the American Medical Association, 288, 2836–2845.PubMedCrossRef
Metadata
Title
Integrating Mental Health and Primary Care Services in the Department of Veterans Affairs Health Care System
Authors
Antonette M. Zeiss
Bradley E. Karlin
Publication date
01-03-2008
Publisher
Springer US
Published in
Journal of Clinical Psychology in Medical Settings / Issue 1/2008
Print ISSN: 1068-9583
Electronic ISSN: 1573-3572
DOI
https://doi.org/10.1007/s10880-008-9100-4

Other articles of this Issue 1/2008

Journal of Clinical Psychology in Medical Settings 1/2008 Go to the issue