title: Association Between Mental Health Staffing Level and Primary Care-Mental Health Integration Level on Provision of Depression Care in Veteran's Affairs Medical Facilities.
abstract: We examined the association of mental health staffing and the utilization of primary care/mental health integration (PCMHI) with facility-level variations in adequacy of psychotherapy and antidepressants received by Veterans with new, recurrent, and chronic depression. Greater likelihood of adequate psychotherapy was associated with increased (1) PCMHI utilization by recurrent depression patients (AOR 1.02; 95% CI 1.00, 1.03); and (2) staffing for recurrent (AOR 1.03; 95% CI 1.01, 1.06) and chronic (AOR 1.02; 95% CI 1.00, 1.03) depression patients (p < 0.05). No effects were found for antidepressants. Mental health staffing and PCMHI utilization explained only a small amount of the variance in the adequacy of depression care.
authors.affiliation: Health Services Research & Development (HSR&D), Veteran Affairs (VA) Puget Sound Health Care System, 1660 Columbian Way, Seattle, WA, 98108, USA.
authors.forename: Denise C
authors.initials: DC
authors.lastname: Cooper
authors.affiliation: Health Services Research & Development (HSR&D), Veteran Affairs (VA) Puget Sound Health Care System, 1660 Columbian Way, Seattle, WA, 98108, USA.|Department of Health Services, University of Washington, Seattle, WA, USA.
authors.forename: Christian D
authors.initials: CD
authors.lastname: Helfrich
authors.affiliation: Geriatric Research, Education, and Clinical Center, VA Puget Sound Health Care System, Seattle, WA, USA.|Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, USA.
authors.forename: Stephen M
authors.initials: SM
authors.lastname: Thielke
authors.affiliation: VA Palo Alto Health Care System, Palo Alto, CA, USA.|Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, CA, USA.
authors.forename: Ranak B
authors.initials: RB
authors.lastname: Trivedi
authors.affiliation: Health Services Research & Development (HSR&D), Veteran Affairs (VA) Puget Sound Health Care System, 1660 Columbian Way, Seattle, WA, 98108, USA.|Department of Medicine, University of Washington, Seattle, WA, USA.
authors.forename: Karin M
authors.initials: KM
authors.lastname: Nelson
authors.affiliation: Health Services Research & Development (HSR&D), Veteran Affairs (VA) Puget Sound Health Care System, 1660 Columbian Way, Seattle, WA, 98108, USA.|Department of Health Services, University of Washington, Seattle, WA, USA.
authors.forename: Gayle E
authors.initials: GE
authors.lastname: Reiber
authors.affiliation: Health Services Research & Development (HSR&D), Veteran Affairs (VA) Puget Sound Health Care System, 1660 Columbian Way, Seattle, WA, 98108, USA.
authors.forename: Evercita C
authors.initials: EC
authors.lastname: Eugenio
authors.affiliation: Health Services Research & Development (HSR&D), Veteran Affairs (VA) Puget Sound Health Care System, 1660 Columbian Way, Seattle, WA, 98108, USA.
authors.forename: Kristine
authors.initials: K
authors.lastname: Beaver
authors.affiliation: Health Services Research & Development (HSR&D), Veteran Affairs (VA) Puget Sound Health Care System, 1660 Columbian Way, Seattle, WA, 98108, USA.
authors.forename: Julie
authors.initials: J
authors.lastname: Nugent-Carney
authors.affiliation: Health Services Research & Development (HSR&D), Veteran Affairs (VA) Puget Sound Health Care System, 1660 Columbian Way, Seattle, WA, 98108, USA. Vincent.fan@va.gov.|Department of Medicine, University of Washington, Seattle, WA, USA. Vincent.fan@va.gov.
authors.forename: Vincent S
authors.initials: VS
authors.lastname: Fan
mesh_terms: D000928:Antidepressive Agents / Q000627:therapeutic use*; D003866:Depressive Disorder / Q000628:therapy*; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D008605:Mental Health Services / Q000458:organization & administration*; D008875:Middle Aged; D016017:Odds Ratio; D010561:Personnel Staffing and Scheduling / Q000706:statistics & numerical data*; D011320:Primary Health Care / Q000458:organization & administration*; D011613:Psychotherapy / Q000706:statistics & numerical data*; D011787:Quality of Health Care; D014481:United States; D014493:United States Department of Veterans Affairs
chemical_list: D000928:Antidepressive Agents
keywords: Antidepressants; Depression; Integrated care; Psychotherapy; Staffing