J Am Board Fam Med 2021 Mar-Apr;34(2):268-290
From the Department of Health Care Policy, Harvard Medical School, Boston, MA (VP-P, HL, HNZ, RCK); the Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY (VP-P); the Center for the Study of Healthcare Innovation, Implementation, and Policy, VA Greater Los Angeles Healthcare System, Los Angeles, CA (LBL); the Division of General Internal Medicine, and Health Services Research, UCLA David Geffen School of Medicine, Los Angeles, CA (LBL); the Department of Behavioral Medicine and Psychiatry, West Virginia University, Morgantown, (RMB); the Center of Excellence for Suicide Prevention, Canandaigua VAMC, Canandaigua, NY (RMB, HL, WRP); the VA Ann Arbor, Center for Clinical Management Research, Ann Arbor, MI (CB, JNK, EPP); the Department of Psychiatry, University of Rochester Medical Center, Rochester, NY (WRP); the Department of Medicine, University of Michigan Medical School, Ann Arbor (EPP); the Cpl Michael J Crescenz VA Medical Center, VISN 4 Mental Illness Research Education and Clinical Center, Philadelphia, PA (DWO); the Perelman School of Medicine, University of Pennsylvania, Philadelphia (DWO).
Introduction: The Veterans Health Administration (VHA) supports the nation's largest primary care-mental health integration (PC-MHI) collaborative care model to increase treatment of mild to moderate common mental disorders in primary care (PC) and refer more severe-complex cases to specialty mental health (SMH) settings. It is unclear how this treatment assignment works in practice.
Methods: Patients (n = 2610) who sought incident episode VHA treatment for depression completed a baseline self-report questionnaire about depression severity-complexity. Read More