Ever tried to get a mental health care appointment as a new patient? How long can you wait before seeing someone? How many phone calls before throwing up your hands in frustration? Problems with the system include a complicated referral system, the need to obtain written referral forms from a primary care physician, trouble finding clinicians who will take one's insurance, struggles to find clinicians who are accepting new patients, inconvenient treatment locations, and long waiting times. The process can be demoralizing, leading to increased desperation, disrupted continuity of care or even the failure to obtain proper care at all.
One approach to the problem has called for greater integration of mental health care professionals in primary care/general practitioner treatment settings. In a new study published in the journal Psychiatric Services, Dutch researchers examined the effects of having mental health care professionals (psychologists and psychiatric nurses) working on site at primary care practices. Known as a collaborative care model, mental health clinicians worked in tandem with primary care physicians and were available to meet patients for clinical assessment, brief psychotherapeutic intervention (maximum of four sessions), and, if needed, referral to more specialized psychiatric services.
The collaborative care treatment settings were compared with treatment-as-usual clinical practices in which patients identified by primary care doctors as needing mental health services were referred to external mental health practitioners/agencies. 165 patients participated and were evaluated after twelve months.
Both collaborative care and treatment-as-usual settings were effective and not significantly different in terms of reducing patients' psychopathology, increasing their quality of life, and obtaining patient satisfaction.
However, in the collaborative care model:
-First meeting with a mental health care professional occurred much more quickly (average of just under 3 weeks versus over 6 weeks in treatment-as-usual settings).
-Patients showed similar improvements, but needed fewer sessions to get there...
-...leading to significantly lower treatment costs (an average yearly savings of $725 per patient).
-Fewer patients remained in treatment after 12 months, presumably because they no longer felt the need for treatment services, though this is unclear.
-General practitioners were significantly more satisfied with their time saved, workload reduction, and patient improvement.
Having mental health providers on-site and working collaboratively with primary care physicians seems to provide better access to care, make good fiscal sense, and give relief to an overtaxed health care system. When choosing a primary care provider, it would be wise to find out if there's a (mental health) doctor in the house.
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What are your thoughts about access to mental health services? Have ideas about improving the process? Comment below! Email correspondence to jareddefifept@gmail.com.
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