title: Unmet need for mental health care among veterans receiving palliative care: assessment is not enough.
abstract: OBJECTIVE
  To determine whether inpatient palliative care teams' assessments of psychological distress affect receipt of in-hospital mental health care (psychotherapy, psychological support, and health and behavior interventions) for seriously ill veterans.
  
  
  METHODS
  Retrospective review of medical records from 287 seriously ill veterans who received inpatient palliative care consults between 2008 and 2010 in the NY/NJ Veterans Healthcare Network.
  
  
  RESULTS
  Of the veterans who were cognitively or physically able to answer questions on the Condensed Memorial Symptom Assessment Scale, 44% reported psychological distress. Of those with distress, 38% accessed mental health care. In logistic regression models adjusted for sociodemographic and health characteristics, there was no evidence that psychological distress reported during the palliative care consult was associated with subsequent mental health care receipt from any type of provider.
  
  
  CONCLUSIONS
  Efforts to increase mental health care to psychologically distressed palliative care patients need to convert assessments into receipt of needed care.
authors.affiliation: James J Peters Veterans Administration Medical Center, Bronx, NY; Icahn School of Medicine at Mount Sinai, New York, NY. Electronic address: melissa.garrido@mssm.edu.
authors.forename: Melissa M
authors.initials: MM
authors.lastname: Garrido
authors.affiliation: James J Peters Veterans Administration Medical Center, Bronx, NY; Icahn School of Medicine at Mount Sinai, New York, NY.
authors.forename: Joan D
authors.initials: JD
authors.lastname: Penrod
authors.affiliation: Dana-Farber Cancer Institute, Boston, MA; Harvard Medical School, Boston, MA.
authors.forename: Holly G
authors.initials: HG
authors.lastname: Prigerson
mesh_terms: D000368:Aged; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data; D006801:Humans; D008605:Mental Health Services / Q000600:supply & distribution*; D020380:Needs Assessment; D010166:Palliative Care / Q000706:statistics & numerical data; D012189:Retrospective Studies; D013315:Stress, Psychological / Q000453:epidemiology / Q000628:therapy; D014481:United States / Q000453:epidemiology; D014728:Veterans / Q000523:psychology* / Q000706:statistics & numerical data
keywords: Veterans; access to care; anxiety; depression; palliative care; psychotherapy