Talk to the Veterans Crisis Line now
U.S. flag
An official website of the United States government

Health Services Research & Development

Veterans Crisis Line Badge
Go to the ORD website
Go to the QUERI website

2011 HSR&D National Meeting Abstract

Printable View

2011 National Meeting

3048 — Limited Adoption of Integrated Mental Health Services in Primary Care, Findings from a National Survey of VA Primary Care Directors.

Klap RS (VA HSR&D Center for the Study of Healthcare Provider Behavior), Stockdale SE (VA HSR&D Center for the Study of Healthcare Provider Behavior), Danielle RE (VA HSR&D Center for the Study of Healthcare Provider Behavior), Ismelda I (VA HSR&D Center for the Study of Healthcare Provider Behavior), Yano EM (VA HSR&D Center for the Study of Healthcare Provider Behavior)

Objectives:
Community Based Outpatient Clinics (CBOCs) play a critical role in improving Veterans’ access to care, particularly in rural areas. There are concerns that CBOCs may not offer the same quality of care at VA Medical Centers. Here we look at the availability of integrated mental health care /primary care models at Community Based Outpatient Clinics compared to VA Medical Centers (VAMCs).

Methods:
We queried primary care (PC) directors from a census of VAMCs and CBOCs serving 20,000+ PC patients in FY2006 (n = 225, 90% response rate). Excluding sites with no mental health clinics (n = 4), we created an analytic sample of 135 (62%) PC programs at VAMCs and 81 CBOCs (38%). We asked primary care directors if the following models existed at their site: co-located collaborative mental health (i.e., MH provider in PC); TIDES model of primary care/ mental health care management; Behavioral Health Laboratory; mental health provider in primary care, and; health psychology. Response options included: fully or partially implemented, planned or neither planned nor implemented. We compared responses of VAMCs and CBOCs using Fisher’s exact test.

Results:
Compared to VAMCs, CBOCs were more likely to report full implementation of co-located collaborative mental health care (39% of CBOCs v. 21% of VAMCs), but they were also more likely to report that this model was neither planned nor implemented (30% of CBOCs v. 20% of VAMCs)(p < 0.01). For mental health primary care, CBOCs were less likely to report full implementation (11% of CBOCs v. 20% of VAMCs), and more likely to report that the models was neither planned not implemented (82% of CBOCs v. 50% of VAMCs)(p < 0.001).

Implications:
Two of the five integrated mental health/primary care models in VA were less likely to be either planned or implemented at CBOCs, compared to VAMCs.

Impacts:
Future research should identify barriers and facilitators to adoption of integrated mental health /primary care among CBOCs.


Questions about the HSR&D website? Email the Web Team.

Any health information on this website is strictly for informational purposes and is not intended as medical advice. It should not be used to diagnose or treat any condition.