Abstract
The association between facility-level organizational features and management of mental health services was assessed based on a survey of directors from 219 VA primary care facilities. Overall, 26.4% of VA primary care facilities referred patients with depression, while 72.6% and 46.1% referred patients with serious mental illness and substance use disorders, respectively Staffing mix (i.e., physician extenders such as nurse practitioners) was associated with a lesser likelihood of mental health referral. Managed care (preauthorization requirement) was associated with a greater likelihood of referral for depression. VA primary care programs, while tending to refer for more serious mental illnesses, may also be using mental health specialists and physician extenders to provide mental health care within general medical settings.
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Acknowledgments
This research reported here was supported by the Department of Veterans Affairs, Veterans Health Administration (VA), Health Services Research and Development Service (IIR 02-283-2; A. Kilbourne, PI), the VA Survey of Primary Care Practices Study (IIR MPC 97–012; EM Yano, PI), and the VA Mental Health Strategic Health Group. This work was also completed with the support of the Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System (M. Fine, PI) and the VA Mental Illness Research Education and Clinical Center awarded to the VA Pittsburgh Healthcare System and the Philadelphia VA Medical Center (I. Katz and G. Haas, Co-PIs). Dr. Kilbourne is funded by a Career Development Award Merit Review Entry Program from the VA Health Services Research and Development program.
The views expressed in this article are those of the authors and do not necessarily represent the views of the Department of Veterans Affairs.
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Kilbourne, A.M., Pincus, H.A., Schutte, K. et al. Management of Mental Disorders in VA Primary Care Practices. Adm Policy Ment Health 33, 208–214 (2006). https://doi.org/10.1007/s10488-006-0034-6
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DOI: https://doi.org/10.1007/s10488-006-0034-6