title: Mental health service use for adult patients with co-occurring depression and physical chronic health care needs, 2007-2010.
abstract: BACKGROUND
  Individuals with mental illness experience poor health and may die prematurely from chronic illness. Understanding whether the presence of co-occurring chronic physical health conditions complicates mental health treatment is important, particularly among patients seeking treatment in primary care settings.
  
  
  OBJECTIVE
  Examine (1) whether the presence of chronic physical conditions is associated with mental health service use for individuals with depression who visit a primary care physician, and (2) whether race modifies this relationship.
  
  
  METHODS
  Secondary analysis of the National Ambulatory Medical Care Survey, a survey of patient-visits collected annually from a random sample of 3000 physicians in office-based settings.
  
  
  METHODS
  Office visits from 2007 to 2010 were pooled for adults aged 35-85 with a depression diagnosis at the time of visit (N=3659 visits).
  
  
  METHODS
  Mental health services were measured using a dichotomous variable indicating whether mental health services were provided during the office visit or a referral made for: (1) counseling, including psychotherapy and other mental health counseling and/or (2) prescribing of psychotropic medications.
  
  
  RESULTS
  Most patient office visits (70%) where a depression diagnosis was recorded also had co-occurring chronic physical conditions recorded. The presence of at least 1 physical chronic condition was associated with a 6% decrease in the probability of receiving any mental health services (P<0.05). There were no differences in service use by race/ethnicity after controlling for other factors.
  
  
  CONCLUSIONS
  Additional research is needed on medical care delivery among patients with co-occurring health conditions, particularly as the health care system moves toward an integrated care model.
authors.affiliation: *Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, NC †Food Systems and Health Analyst/Food and Environment Program Union of Concerned Scientists, Washington, DC ‡Department of Health Policy and Management, Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, NC §Cecil G. Sheps Center for Health Services Research ∥Department of Health Policy and Management, Gillings School of Global Public Health ¶Lineberger Comprehensive Cancer Center #Division of Pharmaceutical Outcomes and Policy, Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC.
authors.forename: Mónica Pérez
authors.initials: MP
authors.lastname: Jolles
authors.forename: Lindsey
authors.initials: L
authors.lastname: Haynes-Maslow
authors.forename: Megan C
authors.initials: MC
authors.lastname: Roberts
authors.forename: Stacie B
authors.initials: SB
authors.lastname: Dusetzina
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care / Q000706:statistics & numerical data*; D002908:Chronic Disease / Q000453:epidemiology*; D015897:Comorbidity; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D008605:Mental Health Services / Q000706:statistics & numerical data*; D008875:Middle Aged; D020380:Needs Assessment / Q000706:statistics & numerical data*; D009819:Office Visits / Q000706:statistics & numerical data; D010808:Physical Examination / Q000706:statistics & numerical data; D012044:Regression Analysis; D014481:United States / Q000453:epidemiology