Missed Opportunities for Depression Screening and Treatment in the United States

Kato, Elisabeth; Borsky, Amanda; Zuvekas, Samuel H.; Soni, Anita; Ngo‐Metzger, Quyen

doi:10.3122/jabfm.2018.03.170406

Cited by 39 publications

(47 citation statements)

References 22 publications

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“…However, improving access to primary care services alone is likely insufficient to fully address mental health disparities. Even if seen in primary care, Blacks and Hispanics are substantially less likely to be screened for mental health problems (Akincigil & Matthews, 2017;Kato et al, 2018). Notably, we did not find that, once in treatment, disparities in the number of mental health-related visits or prescription drugs widened at higher levels of psychological distress.…”

Section: Discussioncontrasting

confidence: 62%

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Do Racial and Ethnic Disparities in Mental Health Treatment Vary With Underlying Mental Health?

Biener

Zuvekas

2020

Med Care Res Rev

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A long line of studies document substantial and persistent racial and ethnic disparities in the use of mental health services. Many recent studies follow the Institute of Medicine’s definition of disparities, adjusting only for differences in health and mental health status across groups. However, controlling for mental health may mask important changes in the magnitudes of disparities at different levels of mental health need. We extend the previous literature by explicitly estimating how differences in treatment use across groups change at different levels of psychological distress. We used detailed data on sociodemographic characteristics, health insurance coverage, treatment, and the K6 psychological distress scale from the 2010 to 2015 Medical Expenditure Panel Survey to estimate nonlinear models of ambulatory and prescription drug mental health treatment. We find that in contrast to physical health treatment, Black–White and Hispanic–White disparities in any mental health treatment use widen with higher levels of psychological distress.

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Section: Discussioncontrasting

confidence: 62%

Section: Discussionmentioning

confidence: 99%

Do Racial and Ethnic Disparities in Mental Health Treatment Vary With Underlying Mental Health?

Biener

Zuvekas

2020

Med Care Res Rev

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“…Another avenue for individual-level interventions that warrants attention is the treatment of mental illnesses, especially major affective disorders. Research indicates that physicians are less likely to screen and treat depression and suicide in the elderly, especially male patients [49,50]. It is essential to reduce elderly suicides there needs to be more mental healthcare providers who are easily accessible, affordable, and acceptable to the elderly [21].…”

Section: Individual-level Interventionsmentioning

confidence: 99%

Firearm Suicides in the Elderly: A Narrative Review and Call for Action

Price

Khubchandani

2021

J Community Health

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Firearm suicides are one of the leading causes of death for older Americans. The purpose of this review is to explore the risk factors associated with suicides in the elderly, provide an overview of the epidemiology of firearm-related suicides in older Americans, and explore methods of preventing firearm suicides in the elderly. The vast majority (70 %) of elderly suicides in the U.S were committed using a firearm. Elderly firearm suicides have increased by 49 % between 2010 and 2018, disproportionately affecting white males. Yearly firearm suicides in the elderly ranged from 4,276 in 2010 to 6,375 in 2018. In 2018, the rate of elderly male firearm suicides was 24.96/100,000 compared to a rate of 1.92/100,000 for elderly females, a rate ratio of 13 to 1 for males compared to females. The primary risk factors for elderly firearm suicides seem to be physical illnesses, mental illnesses, and social factors. Older Americans engage in suicidal behaviors with greater planning and lethality of intent than do young adults. Of all the strategies to prevent suicides with firearms, the most efficacious measures based on current research seem to be state firearm legislation and improving mental healthcare, but these effects are not specific to the elderly. Strengthening state firearm laws and improving mental healthcare for the elderly may have promise in preventing elderly firearm-related suicides. Additional implications for practice and research are discussed in this review.

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“…The Medical Expenditure Panel Survey (MEPS) is a nationally representative, population-based survey that offers unique insight into costs, delivery, health status, and access to care in the United States. Kato et al 27 used MEPS data to evaluate the extent to which our adult population (age 35ϩ years) has been screened for depression, as recommended by the US Preventive Services Task Force. Population subgroups less likely to be screened include men, the elderly, minorities, and the uninsured.…”

Section: Preventing and Addressing Chronic Disease In Primary Care Prmentioning

confidence: 99%

Advancing the Science of Implementation in Primary Health Care

Bazemore¹,

Neale²,

Lupo³

et al. 2018

J Am Board Fam Med

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Implementation Science is commonly described as the study of methods and approaches that promote the uptake and use of evidence-based interventions into routine practice and policymaking. In this issue of JABFM, investigators share a wealth of new insights from the frontlines of Implementation Science in primary care: what it is, how we are doing it, and how it is advancing the evidence base of primary care. The breadth of implementation science in primary care is affirmed by the range of topics covered, from thought leader recommendations on future directions for the field, to reports on how best practices in policy and practice are shaping primary care implementation in the United States and Canada. There are also important updates on agents of primary care implementation themselves, such as practice facilitators, geriatric care teams, and family physicians interested in providing obstetric care. Other articles report on novel practice transformation efforts that advance health promotion and disease prevention, and innovative approaches to identifying and addressing social determinants of health in primary care practices and the communities they serve. The articles seem to generate as many new questions as they answer, and highlight the need for continued emphasis on advancing the science of implementation in primary health care. (J Am Board Fam Med 2018;31:307-311.)It is commonly estimated that evidence-based interventions require an average of 17 years to be incorporated into routine practice.1,2 Increasing payer and delivery system interest in narrowing that time gap has rapidly elevated the field of Implementation Science; the study of how evidence-based practice and policy can be effectively communicated, deployed, and brought to scale. Effective and efficient implementation is of particular importance in primary care, which is both the largest delivery platform and niche in the US health care ecology and an area largely neglected in the landscape of health care spending and biomedical research. 3,4 This theme issue of JABFM highlights lessons from, and efforts to advance implementation science in primary care.

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Missed Opportunities for Depression Screening and Treatment in the United States

Cited by 39 publications

References 22 publications

Do Racial and Ethnic Disparities in Mental Health Treatment Vary With Underlying Mental Health?

Do Racial and Ethnic Disparities in Mental Health Treatment Vary With Underlying Mental Health?

Firearm Suicides in the Elderly: A Narrative Review and Call for Action

Advancing the Science of Implementation in Primary Health Care

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