TY - JOUR
KW - Homebound
KW - Interdisciplinary care
KW - Mental Health
KW - Teams
KW - Veterans
AU - B. E. Karlin
AU - M. J. Karel
A1 - 
AB - PURPOSE OF THE STUDY: To promote mental health (MH) service access and quality for veterans with complex and chronic medical, social, and behavioral conditions, the U.S. Department of Veterans Affairs (VA) has integrated a full-time MH provider into each VA home-based primary care (HBPC) team. The goal of the current evaluation is to examine the nature and extent to which MH care processes and practices have been integrated into HBPC nationally. DESIGN AND METHODS: Separate surveys assessing the integration of a wide range of MH care practices and HBPC team processes were sent to MH providers and program directors in each HBPC program in 2010. RESULTS: A total of 132 MH providers representing 119 HBPC programs, and 112 program directors completed the surveys. The most common clinical issues addressed by MH providers were depression, coping with illness and disability, anxiety, caregiver/family stress, and cognitive evaluation. Other team members typically conducted initial MH screenings, with MH providers' time focusing on cases with identified needs. Approximately 40% of MH providers' time was devoted to direct clinical care. Significant time was also spent on team activities, driving, and charting. IMPLICATIONS: Integration of MH services into HBPC is feasible and facilitates service access for a vulnerable population. Mental health care delivery in HPBC generally involves a high degree of interdisciplinary practice. Mental health integration into HBPC may serve as a model for other systems interested in promoting MH care delivery among homebound and other older individuals.
BT - The Gerontologist
C5 - Education & Workforce; Healthcare Disparities; Medical Home
CP - 5
CY - United States
DO - 10.1093/geront/gnt142
IS - 5
JF - The Gerontologist
N2 - PURPOSE OF THE STUDY: To promote mental health (MH) service access and quality for veterans with complex and chronic medical, social, and behavioral conditions, the U.S. Department of Veterans Affairs (VA) has integrated a full-time MH provider into each VA home-based primary care (HBPC) team. The goal of the current evaluation is to examine the nature and extent to which MH care processes and practices have been integrated into HBPC nationally. DESIGN AND METHODS: Separate surveys assessing the integration of a wide range of MH care practices and HBPC team processes were sent to MH providers and program directors in each HBPC program in 2010. RESULTS: A total of 132 MH providers representing 119 HBPC programs, and 112 program directors completed the surveys. The most common clinical issues addressed by MH providers were depression, coping with illness and disability, anxiety, caregiver/family stress, and cognitive evaluation. Other team members typically conducted initial MH screenings, with MH providers' time focusing on cases with identified needs. Approximately 40% of MH providers' time was devoted to direct clinical care. Significant time was also spent on team activities, driving, and charting. IMPLICATIONS: Integration of MH services into HBPC is feasible and facilitates service access for a vulnerable population. Mental health care delivery in HPBC generally involves a high degree of interdisciplinary practice. Mental health integration into HBPC may serve as a model for other systems interested in promoting MH care delivery among homebound and other older individuals.
PP - United States
PY - 2014
SN - 1758-5341; 0016-9013
SP - 868
EP - 879
EP - 
T1 - National integration of mental health providers in VA home-based primary care: an innovative model for mental health care delivery with older adults
T2 - The Gerontologist
TI - National integration of mental health providers in VA home-based primary care: an innovative model for mental health care delivery with older adults
U1 - Education & Workforce; Healthcare Disparities; Medical Home
U2 - 24300165
U3 - 10.1093/geront/gnt142
VL - 54
VO - 1758-5341; 0016-9013
Y1 - 2014
ER -