Does integrated behavioral health care reduce mental health disparities for Latinos? Initial findings.

Abstract

Integrated behavioral health care (IBHC) is a model of mental health care service delivery that seeks to reduce stigma and service utilization barriers by embedding mental health professionals into the primary care team. This study explored whether IBHC service referrals, utilization, and outcomes were comparable for Latinos and non-Latino White primary care patients. Data for the current study were collected from 793 consecutive patients (63.8% Latino; M age = 29.02 years [SD = 17.96]; 35.1% under 18 years; 65.3% women; 54.3% uninsured) seen for behavioral health services in 2 primary care clinics during a 10.5 month period. The most common presenting concerns were depression (21.6%), anxiety (18.5%), adjustment disorder (13.0%), and externalizing behavior problems (9.8%). Results revealed that while Latino patients had significantly lower self-reported psychiatric distress, significantly higher clinician-assigned global assessment of functioning scores, and fewer received a psychiatric diagnosis at their initial visit compared to non-Latino White patients, both groups had comparable utilization rates, comparable and clinically significant improvements in symptoms (Cohen’s d values > .50), and expressed high satisfaction with integrated behavioral services. These data provide preliminary evidence suggesting integration of behavioral health services into primary care clinics may help reduce mental health disparities for Latinos.

Improving Patient-Centered Care by Assessing Patient Preferences for Multiple Sclerosis Disease-Modifying Agents: A Stated-Choice Experiment

“…4,56,57 The preoperative gallstone nomogram developed by Parmar et al 57 is a useful tool for predicting risk of recurrent gallstone complications and can help surgeons weigh the risk of nonoperative intervention against the risk of recurrence.…”

“…54 Although plentiful research has revealed the positive impact of addressing behavioral health issues in primary care settings and empirical evidence shows that integrated care can reduce health disparities, relatively little attention has focused on the unique needs of culturally diverse groups such as African Americans. 42,[55][56][57] A 2016 literature review concluded that "Evidence is lacking about the effectiveness of integrated care offered in a culturally and linguistically competent, patient-centered framework that adequately addresses key concerns and barriers that affect populations at great risk for marginal health." 58 To address this evidence gap, Project THRIVE (Towards Health Recovery and Vital Engagement) offers a promising approach.…”

The association of posttraumatic stress disorder and chronic medical conditions by ethnicity.

“…Previous studies have documented successful interventions among Latino patients using coordinated care, co-located care, and integrated care approaches. Integrated care interventions in these studies were associated with significant improvements in mental health symptoms and functional impairment (Bridges et al, 2014). In addition, our finding may support the development of policies that are informed by differential risk across ethnic groups.…”

The Impact of Integrated Psychological Services in a Safety Net Primary Care Clinic on Medical Utilization

“…The integration of psychological services into primary care offices has been shown to improve patient outcomes such as depression, anxiety, smoking cessation, and weight loss (Sadock, Auerbach, Rybarczyk, & Aggarwal, ). The integrated behavioral health (IBH) model improves access to care in multiple ways including closing the referral gap found in lower income populations (Reno Conference on the Integration of Behavioral Health in Primary Care, ; Cummings, O'Donohue, & Cummings, ), reducing mental health disparities seen in underserved minority ethnic groups in the United States (Bridges et al, ) and providing treatment opportunities for the estimated 60% of patients whose primary medical complaint has a significant behavioral component (Sobel, ).…”