Initial and Follow-Up Evaluations of Integrated Psychological Services for Anxiety and Depression in a Safety Net Primary Care Clinic.
OBJECTIVE
Despite the recognized importance of integrated behavioral health, particularly in safety net primary care, its effectiveness in real world settings has not been extensively evaluated. This article presents 2 successive studies examining the effectiveness of integrated behavioral care in a safety net setting.


METHODS
Study 1 compared the depression and anxiety scores of predominately low-income and minority patients who underwent brief interventions (N = 147) to those of patients from a demographically similar comparison clinic without integrated psychological services, matched on baseline levels of anxiety and depression and length of time between assessments (N = 139). Study 2 did not include a control group but served as a long-term follow-up assessment of anxiety and depression for a subset of 47 patients who finished treatment and could be reached by telephone within 6-18 months of their last session.


RESULTS
Study 1 found that patients from the clinic with integrated psychology services experienced greater decreases in depression and anxiety scores than patients in the control clinic. These effects did not differ as a function of age, gender, or race. Study 2 found that patients continued to decline in depression and anxiety over time, with lower scores at the last session and even lower scores after longer-term follow-up ranging from 6 to18 months. These improvements remained significant when controlling for other interim mental health treatments.


CONCLUSIONS
These results support the short- and long-term treatment effects of brief primary care behavioral interventions, further strengthening the case for integrated behavioral healthcare in safety net settings.
Virginia Commonwealth University.
Elizabeth
E
Sadock
Virginia Commonwealth University.
Paul B
PB
Perrin
Virginia Commonwealth University.
Renée M
RM
Grinnell
Virginia Commonwealth University.
Bruce
B
Rybarczyk
Virginia Commonwealth University.
Stephen M
SM
Auerbach
D000328:Adult; D001008:Anxiety Disorders / Q000503:physiopathology / Q000628:therapy*; D015897:Comorbidity; D003866:Depressive Disorder / Q000503:physiopathology / Q000628:therapy*; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008605:Mental Health Services / Q000458:organization & administration / Q000592:standards; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D011320:Primary Health Care / Q000458:organization & administration / Q000592:standards; D011613:Psychotherapy / Q000379:methods*; D064876:Safety-net Providers / Q000458:organization & administration / Q000592:standards
anxiety; depression; integrated care; primary care psychology