Abstract
Integrating mental health care in the primary care setting has been identified in the literature as a model for increasing access to mental health services and has been associated with enhanced clinical and functional patient outcomes and higher patient satisfaction. The Department of Veterans Affairs (VA), which operates the nation’s largest integrated health care system, has taken a leadership role in creating a health care system in which mental health care is provided in the primary care setting. This article examines VA’s efforts and progress to date in implementing evidence-based models of integrated mental health services nationally in community based outpatient clinics, home based primary care, and outpatient primary clinics at medical facilities. Psychology plays an important role in this progress, as part of an overall interdisciplinary effort, in which all professions are crucially important and work together to promote the overall well-being of patients.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Areán, P. A., Alvidrez, J., Barrera, A., Robinson, G. S., & Hicks, S. (2002). Would older medical patients use psychological services? Gerontologist, 42, 392–398.
Bartels, S. J., Coakley, E. H., Zubritsky, C., Ware, J. H., Miles, K. M., Areán, P. A., et al. (2004). Improving access to geriatric mental health services: A randomized trial comparing treatment engagement with integrated versus enhanced referral care for depression, anxiety, and at-risk alcohol use. American Journal of Psychiatry, 161, 1455–1462.
Chen, H., Coakley, E. H., Cheal, K., Maxwell, J., Costantino, G., Krahn, D. D., et al. (2006). Satisfaction with mental health services in older primary care patients. American Journal of Geriatric Psychiatry, 14, 371–379.
Felker, B. L., Chaney, E., Rubenstein, L. V., Bonner, L. M., Yano, E. M., Parker, L. E., et al. (2006). Developing effective collaboration between primary care and mental health providers. Primary Care Companion to the Journal of Clinical Psychiatry, 8, 12–16.
Hedrick, S. C., Chaney, E. F., Felker, B., Liu, C., Hasenberg, N., Heagerty, P., et al. (2003). Effectiveness of collaborative care depression treatment in Veterans’ Affairs primary care. Journal of Internal Medicine, 18, 9–16.
Karlin, B. E., & Fuller, J. D. (2007). Geriatric mental health service use and treatment outcomes: Implications for primary care practice. Geriatrics, 62, 26–35.
Katon, W., Von Korff, M., Lin, E., Simon, G., Walker, E., Unutzer, J., et al. (1999). Stepped collaborative care for primary care patients with persistent symptoms of depression: A randomized trial. Archives of General Psychiatry, 56, 1109–1115.
Katon, W., Russo, J., Von Korff, M., Lin, E., Simon, G., Bush, T., et al. (2002). Long-term effects of a collaborative care intervention in persistently depressed primary care patients. Journal of Geriatric Internal Medicine, 17, 741–748.
Longman, P. (2007). Best care anywhere: Why VA health care is better than yours. Sausalito: PoliPoint Press.
Liu, C. F., Cedrick, S. C., Chaney, E. F., Heagerty, P., Felker, B., Hasenberg, N., et al. (2003). Cost effectiveness of collaborative care for depression in a primary care veteran population. Psychiatric Services, 54, 698–704.
Oslin, D. W., Ross, J., Sayers, S., Murphy, J., Kane, V., & Katz, I. R. (2006). Screening, assessment, and management of depression in VA primary care clinics. The behavioral health laboratory. Journal of General Internal Medicine, 21, 46–50.
Pignone, M. P., Gaynes, B. N., Rushton, J. L., Burchell, C. M., Orleans, C. T., Mulrow, C. D., et al. (2002). Screening for depression in adults: A summary of the evidence for the U.S. Preventive Services Task Force. Annals of Internal Medicine, 136, 765–76.
Rollman, B. L., Belnap, B. H., Mazumdar, S., Houck, P. R., Zhu, F., Gardner, W., et al. (2005). A randomized trial to improve the quality of treatment for panic and generalized anxiety disorders in primary care. Archives of General Psychiatry, 62, 1332–1341.
Roy-Byrne, P. B., Katon, W., Cowley, D. S., & Russo, J. (2001). A randomized effectiveness trial of collaborative care for patients with panic disorder in primary care. Archives of General Psychiatry, 58, 869–876.
Skultety, K. M., & Zeiss, A. M. (2006). The treatment of depression in older adults in the primary care setting: An evidence-based review. Health Psychology, 25, 665–674.
Speer, D. C., & Schneider, M. G. (2003). Mental health needs of older adults and primary care: Opportunity for interdisciplinary geriatric team practice. Clinical Psychology: Science and Practice, 21, 85–101.
Tai-Seale, M., Bramson, R., Drukker, D., Hurwicz, M. L., Ory, M., Tai-Seale, T., et al. (2005). Understanding primary care physicians’ propensity to assess elderly patients for depression using interaction and survey data. Medical Care, 43, 1217–1224.
Unützer, J., Katon, W., Callahan, C. M., Williams, J. W., Hunkeler, E., Harpole, L., et al. (2002). Collaborative care management of late-life depression in the primary care setting: A randomized controlled trial. Journal of the American Medical Association, 288, 2836–2845.
Author information
Authors and Affiliations
Corresponding author
Additional information
This article is based in part on a presentation by the first author at the 3rd National Conference of the Association of Psychologists in Academic Health Centers (APAHC) in May of 2007 in Minneapolis, Minnesota.
Rights and permissions
About this article
Cite this article
Zeiss, A.M., Karlin, B.E. Integrating Mental Health and Primary Care Services in the Department of Veterans Affairs Health Care System. J Clin Psychol Med Settings 15, 73–78 (2008). https://doi.org/10.1007/s10880-008-9100-4
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10880-008-9100-4