title: Implementation of primary care-mental health integration services in the Veterans Health Administration: program activity and associations with engagement in specialty mental health services.
abstract: This paper describes the status of the Veterans Health Administration (VHA) Primary Care-Mental Health Integration (PC-MHI) services implementation and presents an assessment of associations between receipt of PC-MHI services and likelihood of receiving a second specialty mental health (SMH) appointment following an initial SMH encounter. The total PC-MHI service recipients and encounters/month rose substantially between October 2007 and April 2011. Adjusting for important covariates, the likelihood of receiving a second SMH encounter within 3 months of an index SMH appointment was 1.37 times greater among individuals who had received a PC-MHI encounter within 3 months of the initial SMH appointment. Implementation of VHA PC-MHI services has substantially increased VHA capacity to deliver mental health services in primary care and findings indicate that PC-MHI services are associated with greater engagement in SMH treatment. Implementation of VHA PC-MHI services is progressing with new technical assistance strategies being deployed.
authors.affiliation: Department of Veterans Affairs, Center for Integrated Healthcare, VAWNYHS (116 N), 3495 Bailey Avenue, Buffalo, NY 14215, USA. Laura.wray@va.gov
authors.forename: Laura O
authors.initials: LO
authors.lastname: Wray
authors.forename: Benjamin R
authors.initials: BR
authors.lastname: Szymanski
authors.forename: Lisa K
authors.initials: LK
authors.lastname: Kearney
authors.forename: John F
authors.initials: JF
authors.lastname: McCarthy
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D019033:Delivery of Health Care, Integrated / Q000458:organization & administration*; D005260:Female; D006284:Health Plan Implementation; D006801:Humans; D016015:Logistic Models; D008297:Male; D001523:Mental Disorders / Q000628:therapy*; D008605:Mental Health Services / Q000458:organization & administration / Q000706:statistics & numerical data*; D008875:Middle Aged; D015999:Multivariate Analysis; D010342:Patient Acceptance of Health Care; D011320:Primary Health Care / Q000458:organization & administration*; D014481:United States; D014493:United States Department of Veterans Affairs