TY - JOUR
AU - T. P. Haderlein
AU - A. Dobalian
AU - P. V. Raja
AU - C. Der-Martirosian
A1 - 
AB - BACKGROUND: In the Veterans Health Administration (VA), Primary Care-Mental Health Integration (PC-MHI) clinics offer mental health services embedded in primary care, a strategy shown to reduce overall specialty mental health clinic burden while facilitating prompt referrals when indicated. Among newly initiated patients, same-day access to PC-MHI from primary care increases subsequent specialty mental health engagement. However, the impact of virtual care on the association between same-day access to PC-MHI and subsequent mental health engagement remains unclear. OBJECTIVE: To examine the effects of same-day access to PC-MHI and virtual care use on specialty mental health engagement. METHODS: We used administrative data from 3066 veterans who initiated mental health care at a large, California VA PC-MHI clinic during 3/1/2018 to 2/28/2022 and had no previous mental health visits for at least 2 years prior to the index appointment. We conducted Poisson regression analyses to examine the effects of same-day access to PC-MHI, virtual access to PC-MHI and their combined effect on subsequent specialty mental health engagement. RESULTS: Same-day access to PC-MHI from primary care was positively associated with specialty mental health engagement (IRR = 1.19; 95% CI 1.14-1.24). Virtual access to PC-MHI was negatively associated with specialty mental health engagement (IRR = 0.83; 95% CI 0.79-0.87). The positive effect of same-day access on specialty mental health engagement was smaller among patients who initiated PC-MHI in a virtual visit (IRR = 1.07) compared to in-person visits (IRR = 1.29; 95% CI 1.22-1.36). CONCLUSIONS: Although same-day access to PC-MHI increased overall specialty mental health engagement, the magnitude of this effect varied between in-person and virtual modalities. More research is needed to understand mechanisms of the association between virtual care use, same-day access to PC-MHI, and specialty mental health engagement.
AD - U.S. Department of Veterans Affairs, North Hills, CA, USA. VHA HSR&D Center for the Study of Health care Innovation, Implementation, and Policy (CSHIIP), Greater Los Angeles VA Medical Center, Los Angeles, CA, USA.;Greater Los Angeles VA Medical Center, Los Angeles, CA, USA.;The Ohio State University, Columbus, OH, USA.
AN - 36905315
BT - J Prim Care Community Health
C5 - Healthcare Disparities
DA - Jan-Dec
DO - 10.1177/21501319231159311
DP - NLM
JF - J Prim Care Community Health
LA - eng
N2 - BACKGROUND: In the Veterans Health Administration (VA), Primary Care-Mental Health Integration (PC-MHI) clinics offer mental health services embedded in primary care, a strategy shown to reduce overall specialty mental health clinic burden while facilitating prompt referrals when indicated. Among newly initiated patients, same-day access to PC-MHI from primary care increases subsequent specialty mental health engagement. However, the impact of virtual care on the association between same-day access to PC-MHI and subsequent mental health engagement remains unclear. OBJECTIVE: To examine the effects of same-day access to PC-MHI and virtual care use on specialty mental health engagement. METHODS: We used administrative data from 3066 veterans who initiated mental health care at a large, California VA PC-MHI clinic during 3/1/2018 to 2/28/2022 and had no previous mental health visits for at least 2 years prior to the index appointment. We conducted Poisson regression analyses to examine the effects of same-day access to PC-MHI, virtual access to PC-MHI and their combined effect on subsequent specialty mental health engagement. RESULTS: Same-day access to PC-MHI from primary care was positively associated with specialty mental health engagement (IRR = 1.19; 95% CI 1.14-1.24). Virtual access to PC-MHI was negatively associated with specialty mental health engagement (IRR = 0.83; 95% CI 0.79-0.87). The positive effect of same-day access on specialty mental health engagement was smaller among patients who initiated PC-MHI in a virtual visit (IRR = 1.07) compared to in-person visits (IRR = 1.29; 95% CI 1.22-1.36). CONCLUSIONS: Although same-day access to PC-MHI increased overall specialty mental health engagement, the magnitude of this effect varied between in-person and virtual modalities. More research is needed to understand mechanisms of the association between virtual care use, same-day access to PC-MHI, and specialty mental health engagement.
PY - 2023
SN - 2150-1319 (Print);2150-1319
SP - 21501319231159311
ST - Effects of Virtual Care and Same-Day Access to Integrated Care on Specialty Mental Health Engagement in the Veterans Health Administration
T1 - Effects of Virtual Care and Same-Day Access to Integrated Care on Specialty Mental Health Engagement in the Veterans Health Administration
T2 - J Prim Care Community Health
TI - Effects of Virtual Care and Same-Day Access to Integrated Care on Specialty Mental Health Engagement in the Veterans Health Administration
U1 - Healthcare Disparities
U3 - 10.1177/21501319231159311
VL - 14
VO - 2150-1319 (Print);2150-1319
Y1 - 2023
ER -