TY - JOUR
AU - E. N. Woodward
AU - B. L. Cornwell
AU - L. O. Wray
AU - A. S. Pomerantz
AU - J. E. Kirchner
AU - J. F. McCarthy
AU - L. K. Kearney
A1 - 
AB - OBJECTIVE: Receiving mental health services as part of primary care in the Veterans Health Administration (VHA) might increase engagement in specialty mental health care. The authors reexamined the association between primary care-mental health integration (PCMHI) and continued engagement in specialty mental health care for VHA patients and assessed differences by race and ethnicity. METHODS: The study included 437,051 primary care patients with a first in-person specialty mental health encounter in 2015-2016 (no specialty mental health encounters in prior 12 months), including 46,417 patients with new PCMHI encounters in the year before the first specialty mental health encounter. Multivariable logistic regression assessed odds of follow-up specialty mental health care within 3 months of the first specialty mental health encounter. The dependent variable was care engagement (attending a second specialty mental health appointment); independent variables were whether patients were seen by PCMHI on the same day as the primary care appointment ("same-day access"), the time between PCMHI and first specialty mental health appointments, and race and ethnicity. RESULTS: PCMHI was associated with increased engagement in specialty mental health care for all patients, with a greater likelihood of engagement among non-Hispanic White patients. Same-day access to PCMHI was positively associated with care engagement, with no significant differences by race or ethnicity. PCMHI care within 3 months before a first specialty mental health encounter was associated with greater care engagement. CONCLUSIONS: PCMHI, especially same-day access to PCMHI care, may boost engagement in mental health care, although the study design precluded conclusions regarding causal relationships.
AD - Center for Mental Healthcare and Outcomes Research, Central Arkansas Veterans Healthcare System, U.S. Department of Veterans Affairs (VA), and Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock (Woodward); Serious Mental Illness Treatment Resource and Evaluation Center, Office of Mental Health and Suicide Prevention, Veterans Health Administration, Ann Arbor (Cornwell); VA Center for Integrated Healthcare and Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo (Wray); Office of Mental Health and Suicide Prevention, Veterans Health Administration, Washington, D.C., and Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire (Pomerantz); VA Behavioral Health Quality Enhancement Research Initiative, Central Arkansas Veterans Healthcare System, North Little Rock, and Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock (Kirchner); Center for Clinical Management Research, VA, and Department of Psychiatry, University of Michigan, Ann Arbor (McCarthy); Office of Mental Health and Suicide Prevention, VA, Washington, D.C., and University of Texas Health Science Center at San Antonio, San Antonio, Texas (Kearney).
AN - 38321918
BT - Psychiatr Serv
C5 - Healthcare Disparities; Financing & Sustainability
CP - 4
DA - Apr 1
DO - 10.1176/appi.ps.20220631
DP - NLM
ET - 20240207
IS - 4
JF - Psychiatr Serv
LA - eng
N2 - OBJECTIVE: Receiving mental health services as part of primary care in the Veterans Health Administration (VHA) might increase engagement in specialty mental health care. The authors reexamined the association between primary care-mental health integration (PCMHI) and continued engagement in specialty mental health care for VHA patients and assessed differences by race and ethnicity. METHODS: The study included 437,051 primary care patients with a first in-person specialty mental health encounter in 2015-2016 (no specialty mental health encounters in prior 12 months), including 46,417 patients with new PCMHI encounters in the year before the first specialty mental health encounter. Multivariable logistic regression assessed odds of follow-up specialty mental health care within 3 months of the first specialty mental health encounter. The dependent variable was care engagement (attending a second specialty mental health appointment); independent variables were whether patients were seen by PCMHI on the same day as the primary care appointment ("same-day access"), the time between PCMHI and first specialty mental health appointments, and race and ethnicity. RESULTS: PCMHI was associated with increased engagement in specialty mental health care for all patients, with a greater likelihood of engagement among non-Hispanic White patients. Same-day access to PCMHI was positively associated with care engagement, with no significant differences by race or ethnicity. PCMHI care within 3 months before a first specialty mental health encounter was associated with greater care engagement. CONCLUSIONS: PCMHI, especially same-day access to PCMHI care, may boost engagement in mental health care, although the study design precluded conclusions regarding causal relationships.
PY - 2024
SN - 1075-2730
SP - 369
EP - 377+
ST - Impact of Primary Care-Mental Health Care Integration on Mental Health Care Engagement Across Racial and Ethnic Groups
T1 - Impact of Primary Care-Mental Health Care Integration on Mental Health Care Engagement Across Racial and Ethnic Groups
T2 - Psychiatr Serv
TI - Impact of Primary Care-Mental Health Care Integration on Mental Health Care Engagement Across Racial and Ethnic Groups
U1 - Healthcare Disparities; Financing & Sustainability
U3 - 10.1176/appi.ps.20220631
VL - 75
VO - 1075-2730
Y1 - 2024
ER -