title: Improving access to mental health services via a clinic-wide mental health intervention in a Southeastern US infectious disease clinic.
abstract: Stepleman, Hann, Santos, and House (2006) described a brief psychological consultation model, which aims to improve integration of mental health services into HIV primary care. This retrospective chart review sought to examine which patients in our adult Infectious Disease clinic were served by this model in a one-year period. Furthermore, we examined whether the patients who subsequently engage in mental health care differ demographically from the consult population. Results indicated that 26.1% (n=252) of the patients at our Infectious Disease clinic (n=963; 36% female, 75% racial minority) received a mental health consultation. We observed no statistically significant differences between the consult and clinic populations with respect to gender, age, or race. Moreover, 43.3% (n=109) of those patients served by the consult model received specialized psychiatric care. There were statistically significant racial differences between those patients who engaged specialty psychiatric care and those who did not after receiving a consultation (chi(2)(1)=16.65, p<0.001; 70% racial minority in consult vs. 47.7% racial minority in psychiatric care). While our in-clinic consultation service reached a representative population, we had less success recruiting this diverse patient population into traditional psychiatric care. Future efforts will need to examine how mental health consultation and traditional psychiatric services can best reduce barriers to engagement and retention in care.
authors.affiliation: Center for Health Quality Outcomes and Economic Research, Bedford, VA, USA.
authors.forename: Kathryn A
authors.initials: KA
authors.lastname: Bottonari
authors.forename: Lara M
authors.initials: LM
authors.lastname: Stepleman
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D019033:Delivery of Health Care, Integrated; D005260:Female; D006678:HIV; D006297:Health Services Accessibility; D006301:Health Services Needs and Demand; D006801:Humans; D008297:Male; D008605:Mental Health Services / Q000706:statistics & numerical data; D008875:Middle Aged; D008913:Minority Groups; D011320:Primary Health Care; D044469:Racial Groups; D012017:Referral and Consultation; D044465:White People; D055815:Young Adult