TY - JOUR
KW - Adult
KW - Aged
KW - Antidepressive Agents/therapeutic use
KW - Delivery of Health Care, Integrated/organization & administration
KW - Depression/diagnosis/epidemiology/therapy
KW - Female
KW - Humans
KW - Male
KW - Mass Screening/organization & administration
KW - Mental Health Services/organization & administration
KW - Middle Aged
KW - Primary Health Care/organization & administration
KW - Psychotherapy
KW - Retrospective Studies
KW - Time Factors
KW - United States/epidemiology
KW - Veterans Health
AU - B. R. Szymanski
AU - K. M. Bohnert
AU - K. Zivin
AU - J. F. McCarthy
A1 - 
AB - BACKGROUND: Primary Care-Mental Health Integration (PC-MHI) may improve mental health services access and continuity of care. OBJECTIVE: To assess whether receipt of integrated PC-MHI services on the date of an initial positive depression screen influences receipt of depression treatment among primary care (PC) patients in the Veterans Health Administration. DESIGN: Retrospective cohort study. SUBJECTS: Thirty-six thousand, two hundred and sixty-three PC patients with positive depression screens between October 1, 2009 and September 30, 2010. MAIN MEASURES: Subjects were assessed for depression diagnosis and initiation of antidepressants or psychotherapy on the screening day, within 12 weeks, and within 6 months. Among individuals with PC encounters on the screening day, setting of services received that day was categorized as PC only, PC-MHI, or Specialty Mental Health (SMH). Using multivariable generalized estimating equations (GEE) logistic regression, we assessed likelihood of treatment initiation, adjusting for demographic and clinical measures, including depression screening score. KEY RESULTS: Patients who received same-day PC-MHI services were more likely to initiate psychotherapy (OR: 8.16; 95 % CI: 6.54-10.17) and antidepressant medications (OR: 2.33, 95 % CI: 2.10-2.58) within 12 weeks than were those who received only PC services on the screening day. CONCLUSIONS: Receipt of same-day PC-MHI may facilitate timely receipt of depression treatment.
BT - Journal of general internal medicine
C5 - Key & Foundational; Measures
CP - 3
CY - United States
DO - 10.1007/s11606-012-2218-y
IS - 3
JF - Journal of general internal medicine
N2 - BACKGROUND: Primary Care-Mental Health Integration (PC-MHI) may improve mental health services access and continuity of care. OBJECTIVE: To assess whether receipt of integrated PC-MHI services on the date of an initial positive depression screen influences receipt of depression treatment among primary care (PC) patients in the Veterans Health Administration. DESIGN: Retrospective cohort study. SUBJECTS: Thirty-six thousand, two hundred and sixty-three PC patients with positive depression screens between October 1, 2009 and September 30, 2010. MAIN MEASURES: Subjects were assessed for depression diagnosis and initiation of antidepressants or psychotherapy on the screening day, within 12 weeks, and within 6 months. Among individuals with PC encounters on the screening day, setting of services received that day was categorized as PC only, PC-MHI, or Specialty Mental Health (SMH). Using multivariable generalized estimating equations (GEE) logistic regression, we assessed likelihood of treatment initiation, adjusting for demographic and clinical measures, including depression screening score. KEY RESULTS: Patients who received same-day PC-MHI services were more likely to initiate psychotherapy (OR: 8.16; 95 % CI: 6.54-10.17) and antidepressant medications (OR: 2.33, 95 % CI: 2.10-2.58) within 12 weeks than were those who received only PC services on the screening day. CONCLUSIONS: Receipt of same-day PC-MHI may facilitate timely receipt of depression treatment.
PP - United States
PY - 2013
SN - 1525-1497; 0884-8734
SP - 346
EP - 352
EP - 
T1 - Integrated care: treatment initiation following positive depression screens
T2 - Journal of general internal medicine
TI - Integrated care: treatment initiation following positive depression screens
U1 - Key & Foundational; Measures
U2 - 23150068
U3 - 10.1007/s11606-012-2218-y
VL - 28
VO - 1525-1497; 0884-8734
Y1 - 2013
ER -