Five-Year Mental Health Care Use by Patients Referred to Collaborative Care or to Specialized Care.
OBJECTIVE
This study compared long-term use of mental health care by two groups of patients who had common mental disorders in the Netherlands-those treated in a collaborative care setting and those referred to off-site specialized mental health services if indicated.


METHODS
The study was a retrospective analysis of use of mental health care over five years by 139 patients who participated in a cluster-randomized parent study. The parent study involved 27 general practitioners (GPs) who provided either collaborative care or usual care. In the collaborative care condition, a mental health professional worked on site at the GP's practice and was available to provide short-term treatment. In the usual-care condition, the GP referred the patient to off-site specialized mental health services if indicated; if not indicated, the GP provided usual care. The two treatment groups were compared on the number of mental health care contacts and total treatment duration, the proportion that initiated a new treatment episode after termination of the initial treatment, and time to new treatment.


RESULTS
Patients in the collaborative care condition received about half the number of mental health care contacts as those in the usual-care condition, and no differences were found in the rate of initiation of new treatment episodes after initial treatment, time to new treatment, and total treatment duration.


CONCLUSIONS
Referral of patients with common mental disorders to collaborative mental health care as a first intervention led to fewer contacts with a mental health care professional over the long term, compared with referral to specialized mental health care.
Ms. van Orden and Mr. Deen are with Parnassia Academie, Dr. Hoencamp is with the Indigo Zorgservice, and Dr. Haffmans is with PsyQ, Medical Chronobiology, all at the Parnassia Groep, The Hague, the Netherlands (e-mail: m.vanorden@parnassiagroep.nl ). Mr. Deen, Dr. Haffmans, and Dr. Hoencamp are also with the Faculty of Social and Behavioral Sciences, Leiden University, Leiden, the Netherlands, where Dr. Spinhoven is affiliated.
Mirjam L
ML
van Orden
Ms. van Orden and Mr. Deen are with Parnassia Academie, Dr. Hoencamp is with the Indigo Zorgservice, and Dr. Haffmans is with PsyQ, Medical Chronobiology, all at the Parnassia Groep, The Hague, the Netherlands (e-mail: m.vanorden@parnassiagroep.nl ). Mr. Deen, Dr. Haffmans, and Dr. Hoencamp are also with the Faculty of Social and Behavioral Sciences, Leiden University, Leiden, the Netherlands, where Dr. Spinhoven is affiliated.
Mathijs L
ML
Deen
Ms. van Orden and Mr. Deen are with Parnassia Academie, Dr. Hoencamp is with the Indigo Zorgservice, and Dr. Haffmans is with PsyQ, Medical Chronobiology, all at the Parnassia Groep, The Hague, the Netherlands (e-mail: m.vanorden@parnassiagroep.nl ). Mr. Deen, Dr. Haffmans, and Dr. Hoencamp are also with the Faculty of Social and Behavioral Sciences, Leiden University, Leiden, the Netherlands, where Dr. Spinhoven is affiliated.
Philip
P
Spinhoven
Ms. van Orden and Mr. Deen are with Parnassia Academie, Dr. Hoencamp is with the Indigo Zorgservice, and Dr. Haffmans is with PsyQ, Medical Chronobiology, all at the Parnassia Groep, The Hague, the Netherlands (e-mail: m.vanorden@parnassiagroep.nl ). Mr. Deen, Dr. Haffmans, and Dr. Hoencamp are also with the Faculty of Social and Behavioral Sciences, Leiden University, Leiden, the Netherlands, where Dr. Spinhoven is affiliated.
Judith
J
Haffmans
Ms. van Orden and Mr. Deen are with Parnassia Academie, Dr. Hoencamp is with the Indigo Zorgservice, and Dr. Haffmans is with PsyQ, Medical Chronobiology, all at the Parnassia Groep, The Hague, the Netherlands (e-mail: m.vanorden@parnassiagroep.nl ). Mr. Deen, Dr. Haffmans, and Dr. Hoencamp are also with the Faculty of Social and Behavioral Sciences, Leiden University, Leiden, the Netherlands, where Dr. Spinhoven is affiliated.
Eric
E
Hoencamp
D000328:Adult; D003299:Cooperative Behavior; D005260:Female; D058006:General Practice / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000628:therapy*; D008605:Mental Health Services / Q000706:statistics & numerical data*; D008875:Middle Aged; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D013997:Time Factors