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APHA Scientific Session and Event Listing

Stephen Petterson, PhD and Robert Phillips, MD, MPH. Robert Graham Center, American Academy of Family Physicians, 1350 Connecticut Avenue, N.W., Suite 201, Washington, DC 20036, 202-331-3360, SPetterson@AAFP.org

A growing number of persons with mental health problems obtain treatment from primary care providers. Realistic assessments of this trend indicate policies both to increase the competence of primary care providers and develop collaborative relationship between primary care and mental health providers. Data is from the 2002 and 2003 Medical Expenditure Panel Survey, which includes longitudinal information about all medical events over a two-year period. Our findings show that the primary care and mental health systems are essentially balkanized, with limited evidence of collaboration. For example, for all treatment episodes for depression just 12% involved care from both a primary care physician and a mental health professional. For persons with three or more visits, 63% obtained all treatment outside of primary care and 15% entirely within primary care; only a small proportion (5%) began their treatment in primary care, saw another provider and returned to primary care for a follow-up. Multivariate analyses show that adults with less severe mental health problems are more likely to obtain care only from the mental health sector; those with the most severe problems are more likely to obtain care from a combination of primary care and mental health providers. Adults with both poor physical and mental health are more likely to obtain care solely from primary care providers. Given the greater importance of primary care in the treatment of mental health problems, it is of great urgency to develop and create incentives for far more extensive collaboration across sectors.

Learning Objectives: At the conclusion of the session, the participant (learner) in this session will be able to

• Recognize the importance of addressing the increasingly prominent role of primary care in the treatment of mental health problems;
• Assess available evidence of the current (lack of) collaboration between the primary care and mental health sectors.
• Identify major barriers to effective treatment of mental health problems in primary care.
• Evaluate possible policies aimed at improving care of persons with mental health problems.

Keywords: Mental Health, Primary Care

Presenting author's disclosure statement:

Not Answered