title: Integration of mental health resources in a primary care setting leads to increased provider satisfaction and patient access.
abstract: OBJECTIVE
  This evaluation assessed the opinions and experiences of primary care providers and their support staff before and after implementation of expanded on-site mental health services and related system changes in a primary care clinic.
  
  
  METHODS
  Individual semistructured interviews, which contained a combination of open-ended questions and rating scales, were used to elicit opinions about mental health services before on-site system and resource changes occurred and repeated following changes that were intended to improve access to on-site mental health care.
  
  
  RESULTS
  In the first set of interviews, prior to expanding mental health services, primary care providers and support staff were generally dissatisfied with the availability and scheduling of on-site mental health care. Patients were often referred outside the primary care clinic for mental health treatment, to the detriment of communication and coordinated care. Follow-up interviews conducted after expansion of mental health services, scheduling refinements and other system changes revealed improved provider satisfaction in treatment access and coordination of care. Providers appreciated immediate and on-site social worker availability to triage mental health needs and help access care, and on-site treatment was viewed as important for remaining informed about patient care the primary care providers are not delivering directly.
  
  
  CONCLUSIONS
  Expanding integrated mental health services resulted in increased staff and provider satisfaction. Our evaluation identified key components of satisfaction, including on-site collaboration and assistance triaging patient needs. The sustainability of integrated models of care requires additional study.
authors.affiliation: Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA. Electronic address: vickersdouglas.kristin@mayo.edu.
authors.forename: Kristin S
authors.initials: KS
authors.lastname: Vickers
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Ridgeway
authors.forename: Julie C
authors.initials: JC
authors.lastname: Hathaway
authors.forename: Jason S
authors.initials: JS
authors.lastname: Egginton
authors.forename: Angela B
authors.initials: AB
authors.lastname: Kaderlik
authors.forename: David J
authors.initials: DJ
authors.lastname: Katzelnick
mesh_terms: D001291:Attitude of Health Personnel; D019033:Delivery of Health Care, Integrated / Q000458:organization & administration*; D005260:Female; D006297:Health Services Accessibility / Q000458:organization & administration*; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008605:Mental Health Services / Q000458:organization & administration*; D058007:Physicians, Primary Care / Q000523:psychology; D011320:Primary Health Care / Q000458:organization & administration*; D012017:Referral and Consultation / Q000458:organization & administration
keywords: Anxiety disorders; Delivery of health care; Integrated; Mental health