Who is at risk of nondetection of mental health problems in primary care?

Borowsky, Steven J.; Rubenstein, Lisa V.; Meredith, Lisa S.; Camp, Patricia; Jackson-Triche, Maga; Wells, Kenneth B.

doi:10.1046/j.1525-1497.2000.12088.x

Cited by 396 publications

(290 citation statements)

References 51 publications

Supporting

Mentioning

261

Contrasting

Unclassified

Order By: Relevance

“…General Practitioners play a crucial role in the detection and referral of mental health problems in primary care (Borowsky, et al, 2000;Bradley, 2008;Copty, 2004;Copty & Whitford, 2005). In Ireland, this is highlighted by current mental health policy as outlined in 'A Vision for Change' (Republic of Ireland Department of Health and Children, 2006), which further augments the role of the GP as a conduit for access to a broad range of mental health services both public and private.…”

Section: Irish General Practitioner Referrals To Psychological Therapiesmentioning

confidence: 99%

Irish General Practitioner referrals to psychological therapies

Cullinan

Veale

Vitale

2015

Ir. j. psychol. Med.

View full text Add to dashboard Cite

ObjectiveGeneral Medical Practitioners play a crucial role in the detection and referral of mental health problems in primary care. This study describes the referral patterns of Irish General Practitioners (GPs) to psychological therapies and profiles the range of psychological therapies available.MethodA 21-item study-specific questionnaire exploring referral processes to psychological therapies was sent to all GPs listed by the Irish College of General Practitioners in one county in Ireland. A 19-item questionnaire exploring details of psychological therapies offered and referral pathways was sent to members of psychological therapy accrediting bodies in the same county.ResultsOf 97 GP respondents (33% response rate), their estimation of the percentage of their patients who have presenting or underlying mental health issues averaged 22%. When asked to indicate which psychological therapies they consider for referrals, psychiatric referrals was the most frequent referral option (94%), followed by Counsellors (69%), Clinical psychologist (60%) and Psychotherapists (30%). GPs indicated they had some or very little knowledge of specific psychological therapies. Of 129 psychological therapists (45% response rate), self-referral and GP referral were their main referral pathways; 80% worked in private practice; highest qualification level was Undergraduate/Higher Diploma (66%), Master Level (39%) and Doctoral Level (5%).ConclusionGPs refer patients presenting with mental health problems to psychiatrists with significantly lower percentages referring to other types of psychological therapists. Findings demonstrate that there is a need for greater education and information-sharing between GPs and providers of accredited psychological therapies to increase knowledge on specific therapies and their evidence base.

show abstract

Section: Irish General Practitioner Referrals To Psychological Therapiesmentioning

confidence: 99%

Irish General Practitioner referrals to psychological therapies

Cullinan

Veale

Vitale

2015

Ir. j. psychol. Med.

View full text Add to dashboard Cite

show abstract

“…7,8 The quality of depression care in primary care also varies by patient race and ethnicity. Even when African Americans discuss emotional concerns, they are often not recognized as being depressed [9][10][11][12] and are less likely than whites to be referred to mental health specialists by their primary care physicians. 13 Attrition from psychotherapy and pharmacotherapy is also higher and rates of guideline-concordant care are lower for African Americans compared to whites.…”

Section: T He Majority Of Individuals With Depression In the Unitedmentioning

confidence: 99%

Patient–Physician Communication in the Primary Care Visits of African Americans and Whites with Depression

et al. 2008

View full text Add to dashboard Cite

“…Black women had higher odds of initiating care in an outpatient mental health setting, but blacks and Latinas who initiated antidepressant use had much lower chances than white women of refilling a prescription. Prior research has revealed that depression preferences for treatment modality differ by race, with blacks and Latinas generally preferring psychotherapy over antidepressant medications (15,45–47) As such, this finding may provide information about patient desire or willingness to refill a prescription or clinician response to patient preferences.…”

Section: Discussionmentioning

confidence: 99%

Racial and Ethnic Disparities in Postpartum Depression Care Among Low-Income Women

Kozhimannil¹

2011

Psychiatric Services

View full text Add to dashboard Cite

Objective The goal of this study was to characterize racial-ethnic differences in mental health care utilization associated with postpartum depression in a multiethnic cohort of Medicaid recipients. Methods In a retrospective cohort study, administrative claims data from New Jersey’s Medicaid program were obtained for 29,601 women (13,001 whites, 13,416 blacks, and 3,184 Latinas) who delivered babies between July 2004 and October 2007. Racial-ethnic differences were estimated with logistic regression for initiation of antidepressant medication or outpatient mental health visits within six months of delivery, follow-up (a prescription refill or second visit), and continued mental health care (at least three visits or three filled antidepressant prescriptions within 120 days). Results Nine percent (N=1,120) of white women initiated postpartum mental health care, compared with 4% (N=568) of black women and 5% (N=162) of Latinas. With analyses controlling for clinical factors, the odds of initiating treatment after delivery were significantly (p<.001) lower for blacks (adjusted odds ratio [AOR]=.43) and Latinas (AOR=.59) compared with whites. Among those who initiated treatment, blacks and Latinas were less likely than whites to receive follow-up treatment (blacks, AOR=.66, p<.001; Latinas, AOR=.67, p<.05) or continued care (blacks, AOR=.81, marginal difference at p<.10; Latinas, AOR=.67, p<.05). Among those who initiated antidepressant treatment, black women and Latinas were less likely than whites to refill a prescription. Conclusions There were significant racial-ethnic differences in depression-related mental health care after delivery. Suboptimal treatment was prevalent among all low-income women in the study. However, racial and ethnic disparities in the initiation and continuation of postpartum depression care were particularly troubling and warrant clinical and policy attention.

show abstract

Who is at risk of nondetection of mental health problems in primary care?

Cited by 396 publications

References 51 publications

Irish General Practitioner referrals to psychological therapies

Irish General Practitioner referrals to psychological therapies

Patient–Physician Communication in the Primary Care Visits of African Americans and Whites with Depression

Racial and Ethnic Disparities in Postpartum Depression Care Among Low-Income Women

Contact Info

Product

Resources

About