Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #122316

Cynthia Zubritsky, PhD, Center for Mental Health Policy and Services Research, University of Pennsylvania, 3535 Market St., Suite 3009, Philadelphia, PA 19104, 215-662-2886, cdz@mail.med.upenn.edu and Elizabeth C. McDonel Herr, PhD, Center for Mental Health Services/DSSI/CSP, Substance Abuse and Mental Health Services Administration, 1 Choke Cherry Rd. Rm 6-1011, Rockville, MD 20857.

As part of a national effort to improve access to mental health and substance abuse services for older adults, the SAMHSA initiated a multisite study, the Primary Care Research in Substance Abuse and Mental Health for the Elderly (PRISM-E) program to compare integrated care (IC) and enhanced specialty referral (ESR) service models for treating mental health and/or substance abuse (MH/SA) conditions in older primary care patients. The study's significant federal partnerships included substantial contributions and collaboration from the Department of Veterans Affairs, the Health Resources and Services Administration, and the Centers for Medicare and Medicaid. Over 25,000 older adults were screened for mental health and alcohol drinking problems in primary care settings at 11 sites, including Philadelphia. More than 2,200 elderly primary care patients with depression, anxiety, and at-risk drinking participated in the study.

Findings from PRISM-E can lead to major improvements in the delivery of MH/SA services to older adults. A brief summary of these findings will be discussed, including: IC was more likely to engage older adults for the first mental health visit than ESR; outcomes for older persons with overall depression were similar for both IC and ESR groups at 6-month follow-up, while outcomes for major depression are slightly superior in ESR; a significant number of older at-risk drinkers can substantially modify their drinking over time, regardless of the particular service delivery model; patient satisfaction ratings were higher in IC, and primary care physicians and MH/SA clinicians at participating clinics preferred IC across several domains.

Learning Objectives:

• 1. Participants will learn how system integration affects older adults’ access to mental health and substance abuse services in primary care settings.
• 2. Participants will learn how patient satisfaction is associated with access to mental health and substance abuse services.
• 3. Participants will learn about organizational and system barriers to improving access to mental health and substance abuse services for older adults.

Presenting author's disclosure statement:

Not Answered

Recorded presentation