title: Embedding a psychologist into primary care increases access to behavioral health services.
abstract: BACKGROUND
  Patients commonly report psychological issues during primary care visits; however, few patients will follow through with a referral for behavioral health services at an outside facility. Therefore, patients may benefit from having psychologists embedded into primary care clinics. The purpose of this study was to determine who saw a primary care psychologist and to investigate which patient characteristics predicted who was more likely to attend subsequent visits with behavioral health services.
  
  
  METHODS
  There were 96 patients referred to a primary care psychologist by their primary care physician. Chart reviews were conducted to obtain patient characteristics and to determine whether the patients attended a subsequent visit with behavioral health services after the initial evaluation.
  
  
  RESULTS
  There were 84.4% of patients who completed an initial evaluation with a psychologist and 15.6% either cancelled or did not show for this evaluation. Of those who completed the initial evaluation, more than half had never received treatment from a behavioral health specialist. Of the 70.4% patients recommended to attend additional behavioral health treatment, 54.4% of patients attended a subsequent visit. Gender, age, race, years of education, and whether a patient had previous behavioral treatment did not predict who was more likely to attend a subsequent behavioral health visit after the initial evaluation.
  
  
  CONCLUSIONS
  Embedding a psychologist in a primary care clinic leads to increased access to behavioral health services, especially among patients who may not seek out these services themselves or follow through with a physician's referral to an outside behavioral health clinic.
authors.affiliation: Behavioral Health Internal Medicine lmatero1@hfhs.org.
authors.forename: Lisa Renee
authors.initials: LR
authors.lastname: Miller-Matero
authors.affiliation: Behavioral Health.
authors.forename: Fatin
authors.initials: F
authors.lastname: Dubaybo
authors.affiliation: Behavioral Health.
authors.forename: Maisa S
authors.initials: MS
authors.lastname: Ziadni
authors.affiliation: Behavioral Health Internal Medicine.
authors.forename: Rachel
authors.initials: R
authors.lastname: Feit
authors.affiliation: Behavioral Health Internal Medicine.
authors.forename: Rachel
authors.initials: R
authors.lastname: Kvamme
authors.affiliation: Behavioral Health.
authors.forename: Anne
authors.initials: A
authors.lastname: Eshelman
authors.affiliation: Internal Medicine.
authors.forename: William
authors.initials: W
authors.lastname: Keimig
mesh_terms: D000328:Adult; D000368:Aged; D003156:Community Mental Health Services / Q000458:organization & administration* / Q000706:statistics & numerical data; D005260:Female; D006297:Health Services Accessibility / Q000458:organization & administration*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care / Q000458:organization & administration* / Q000706:statistics & numerical data; D011584:Psychology
keywords: access to care; patient-centeredness; practice management; primary care; program evaluation