TY - JOUR
KW - Adolescent
KW - Adult
KW - Aged
KW - Databases, Factual
KW - Delivery of Health Care, Integrated
KW - Humans
KW - Male
KW - Mental Disorders/diagnosis/epidemiology
KW - Mental Health Services
KW - Middle Aged
KW - Primary Health Care
KW - United States Department of Veterans Affairs
KW - United States/epidemiology
KW - Young Adult
AU - K. Zivin
AU - P. N. Pfeiffer
AU - B. R. Szymanski
AU - M. Valenstein
AU - E. P. Post
AU - E. M. Miller
AU - J. F. McCarthy
A1 - 
AB - BACKGROUND: Providing collaborative mental health treatment within primary care settings improves depression outcomes and may improve detection of mental disorders. Few studies have assessed the effect of collaborative mental health treatment programs on diagnosis of mental disorders in primary care populations. In 2008, many Department of Veterans Affairs (VA) facilities implemented collaborative care programs, as part of the VA's Primary Care-Mental Health Integration (PC-MHI) program. OBJECTIVES: To assess the prevalence of diagnosed mental health conditions among primary care patient populations in association with PC-MHI programs, overall and for patient subpopulations that may be less likely to receive mental health treatment. RESEARCH DESIGN: Using a difference-in-differences analysis, we evaluated whether the rates of psychiatric diagnoses among primary care patient populations at 294 VA facilities changed from fiscal year (FY)07 to FY08, and whether trends differed at facilities with PC-MHI encounters in FY08. Subgroup analyses examined whether trends differed by patient age and race/ethnicity. SUBJECTS, MEASURES, AND RESULTS: From FY07 to FY08, the prevalence of diagnosed depression, anxiety, post-traumatic stress disorder, and alcohol abuse increased more in the 137 facilities with PC-MHI program encounters than in the 157 facilities without these encounters. Increases were more likely among patients who were younger (18-64) and white. CONCLUSIONS: Initiation of PC-MHI programs was associated with elevated diagnosis patterns, which may enhance recognition of mental health needs among primary care patients. Increases in diagnosis prevalence were not uniform across patient subgroups. Further research is needed on treatment processes and outcomes for individuals receiving services in PC-MHI programs.
BT - Medical care
C5 - General Literature
CP - 9
CY - United States
DO - 10.1097/MLR.0b013e3181e5792b
IS - 9
JF - Medical care
N2 - BACKGROUND: Providing collaborative mental health treatment within primary care settings improves depression outcomes and may improve detection of mental disorders. Few studies have assessed the effect of collaborative mental health treatment programs on diagnosis of mental disorders in primary care populations. In 2008, many Department of Veterans Affairs (VA) facilities implemented collaborative care programs, as part of the VA's Primary Care-Mental Health Integration (PC-MHI) program. OBJECTIVES: To assess the prevalence of diagnosed mental health conditions among primary care patient populations in association with PC-MHI programs, overall and for patient subpopulations that may be less likely to receive mental health treatment. RESEARCH DESIGN: Using a difference-in-differences analysis, we evaluated whether the rates of psychiatric diagnoses among primary care patient populations at 294 VA facilities changed from fiscal year (FY)07 to FY08, and whether trends differed at facilities with PC-MHI encounters in FY08. Subgroup analyses examined whether trends differed by patient age and race/ethnicity. SUBJECTS, MEASURES, AND RESULTS: From FY07 to FY08, the prevalence of diagnosed depression, anxiety, post-traumatic stress disorder, and alcohol abuse increased more in the 137 facilities with PC-MHI program encounters than in the 157 facilities without these encounters. Increases were more likely among patients who were younger (18-64) and white. CONCLUSIONS: Initiation of PC-MHI programs was associated with elevated diagnosis patterns, which may enhance recognition of mental health needs among primary care patients. Increases in diagnosis prevalence were not uniform across patient subgroups. Further research is needed on treatment processes and outcomes for individuals receiving services in PC-MHI programs.
PP - United States
PY - 2010
SN - 1537-1948; 0025-7079
SP - 843
EP - 851
EP - 
T1 - Initiation of primary care-mental health integration programs in the VA Health System: Associations with psychiatric diagnoses in primary care
T2 - Medical care
TI - Initiation of primary care-mental health integration programs in the VA Health System: Associations with psychiatric diagnoses in primary care
U1 - General Literature
U2 - 20706160
U3 - 10.1097/MLR.0b013e3181e5792b
VL - 48
VO - 1537-1948; 0025-7079
Y1 - 2010
ER -