TY - JOUR
KW - Adult
KW - Aged
KW - Delivery of Health Care, Integrated/organization & administration
KW - Female
KW - Humans
KW - Logistic Models
KW - Male
KW - Mental Health Services/organization & administration
KW - Mental Health/standards
KW - Middle Aged
KW - Primary Health Care/organization & administration
KW - Psychiatric Status Rating Scales
KW - Stress Disorders, Post-Traumatic/diagnosis
KW - Time Factors
KW - United States
KW - United States Department of Veterans Affairs
KW - Veterans/psychology
AU - K. M. Bohnert
AU - R. K. Sripada
AU - J. Mach
AU - J. F. McCarthy
A1 - 
AB - OBJECTIVE: The study examined whether same-day integrated mental health services are associated with increased diagnosis and treatment initiation among primary care patients with positive posttraumatic stress disorder (PTSD) screens. METHODS: Data were from a national sample of Veterans Health Administration (VHA) primary care patients with a positive PTSD screen (N=21,427). Patients were assessed for PTSD diagnosis and treatment initiation on the screening day and </= 7 days, </= 12 weeks, </= 6 months, and </= 1 year after screening positive. The service setting on screening day was categorized as primary care only, same-day primary care-mental health integration (PC-MHI), or same-day specialty mental health care. Multivariable generalized estimating equations logistic regression was used to estimate associations between category of screening day services and diagnosis and treatment initiation, with adjustment for demographic characteristics, prior psychiatric diagnoses, prior VHA service utilization, and PTSD screen score. RESULTS: Of the 21,427 patients with positive PTSD screens, 10,809 (50.4%) received a diagnosis within one year of screening positive. Same-day PC-MHI services were associated with greater odds of PTSD diagnosis, both on the same day as (odds ratio [OR]=2.23) and one year (OR=1.67) after screening positive compared with primary care-only services (p<.001). Among those who received a diagnosis on the same day as their positive screen, same-day PC-MHI services were associated with increased odds of initiating PTSD treatment (OR=3.39) within 12 weeks of diagnosis, compared with primary care only (p<.001). CONCLUSIONS: Same-day integrated mental health services may help facilitate PTSD diagnosis and treatment initiation after a positive screen.
BT - Psychiatric services (Washington, D.C.)
C5 - Healthcare Disparities; Measures
CP - 1
CY - United States
DO - 10.1176/appi.ps.201500035
IS - 1
JF - Psychiatric services (Washington, D.C.)
N2 - OBJECTIVE: The study examined whether same-day integrated mental health services are associated with increased diagnosis and treatment initiation among primary care patients with positive posttraumatic stress disorder (PTSD) screens. METHODS: Data were from a national sample of Veterans Health Administration (VHA) primary care patients with a positive PTSD screen (N=21,427). Patients were assessed for PTSD diagnosis and treatment initiation on the screening day and </= 7 days, </= 12 weeks, </= 6 months, and </= 1 year after screening positive. The service setting on screening day was categorized as primary care only, same-day primary care-mental health integration (PC-MHI), or same-day specialty mental health care. Multivariable generalized estimating equations logistic regression was used to estimate associations between category of screening day services and diagnosis and treatment initiation, with adjustment for demographic characteristics, prior psychiatric diagnoses, prior VHA service utilization, and PTSD screen score. RESULTS: Of the 21,427 patients with positive PTSD screens, 10,809 (50.4%) received a diagnosis within one year of screening positive. Same-day PC-MHI services were associated with greater odds of PTSD diagnosis, both on the same day as (odds ratio [OR]=2.23) and one year (OR=1.67) after screening positive compared with primary care-only services (p<.001). Among those who received a diagnosis on the same day as their positive screen, same-day PC-MHI services were associated with increased odds of initiating PTSD treatment (OR=3.39) within 12 weeks of diagnosis, compared with primary care only (p<.001). CONCLUSIONS: Same-day integrated mental health services may help facilitate PTSD diagnosis and treatment initiation after a positive screen.
PP - United States
PY - 2016
SN - 1557-9700; 1075-2730
SP - 94
EP - 100
EP - 
T1 - Same-Day Integrated Mental Health Care and PTSD Diagnosis and Treatment Among VHA Primary Care Patients With Positive PTSD Screens
T2 - Psychiatric services (Washington, D.C.)
TI - Same-Day Integrated Mental Health Care and PTSD Diagnosis and Treatment Among VHA Primary Care Patients With Positive PTSD Screens
U1 - Healthcare Disparities; Measures
U2 - 26423103
U3 - 10.1176/appi.ps.201500035
VL - 67
VO - 1557-9700; 1075-2730
Y1 - 2016
ER -