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

Abstract

Older primary care patients are more likely to accept collaborative mental health treatment within primary care than in mental health/substance abuse clinics. These results suggest that integrated service arrangements improve access to mental health and substance abuse services for older adults who underuse these services.

Eldre med selvmordsrisiko: behandling og oppfølging

“…En nyere amerikansk studie viste at eldre i større grad nyttiggjorde seg psykiatriske helsetjenester som var integrert i primaerhelsetjenesten sammenlignet med en vanlig henvisningspraksis til spesialist (Bartels et al, 2004). Å øke beredskapen omkring de eldres psykiske helse i primaerhelsetjenesten, helst i integrert samarbeid med alderspsykiatrisk spesialisttilbud, blir derfor et viktig mål i forhold til oppfølging av selvmordstruete eldre.…”

Santé mentale en première ligne

“…La mise en place de soins partagés demande aussi de la préparation, du temps, des structures de soutien et un financement approprié (Byng et al, 2004). La collaboration serait davantage développée lorsque les intervenants des soins primaires et les spécialistes de la santé mentale se retrouvent dans un même emplacement ou du moins, à proximité (Bray et Rogers, 1995 ;Bartels et al, 2004). Elle serait aussi plus propice à se développer sous un mode de financement par capitation (Goldberg, 1999 ;Lamarche et al, 2003).…”

Personal characteristics and depression-related attitudes of older adults and participation in stages of implementation of a multi-site effectiveness trial (PRISM-E)

“…Based on bivariate associations with our dependent variable, participation at each step of recruitment and treatment participation, we included covariates in multivariate models that we found were associated at the p < 0.20 level. For models in which having met with the health specialist was the dependent variable, we have included a term representing whether the participant was randomized to integrated behavioral health care versus enhanced referral care because persons who were randomized to the integrated care condition have been reported to be more likely to engage the health specialist (Bartels et al, 2004). Our measure of association was the odds ratio (Hosmer and Lemeshow, 2000).…”