The Influence of Integration on the Expenditures and Costs of Mental Health and Substance Use Care: Results from the Randomized PRISM-E Study

Domino, Marisa Elena; Maxwell, James; Cody, Marisue; Cheal, Karen; Busch, Alisa B.; Stone, William W. Van; Cooley, Susan; Zubtritsky, C.; Estes, Carroll L.; Shen, Yu‐Chu; Lynch, Marty; Grantham, Susan; Wohlford, Paul; Aoyama, Maho; Fitzpatrick, Joyce J.; Zaman, Saminaz; Dodson, John A.; Levkoff, Sue E.

doi:10.1007/s12126-008-9010-7

Cited by 10 publications

(9 citation statements)

References 42 publications

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“…Thus clinician behaviors and patient problems were closer to the typical clinical situation than in studies focused on a single, pure diagnostic group with highly structured treatment protocols. It is important to note that the cost of mental health and substance abuse treatment per patient per year did not differ significantly across models (28). Further analyses on cost of care will be presented in subsequent papers.…”

Section: Discussionmentioning

confidence: 97%

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PRISM-E: Comparison of Integrated Care and Enhanced Specialty Referral Models in Depression Outcomes

Krahn¹,

Bartels²,

Coakley³

et al. 2006

Psychiatric Services

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Section: Discussionmentioning

confidence: 97%

“…Other studies have used a four-visit criterion over a six-or 12-month period as a benchmark for minimally adequate care (28). Perhaps at these minimally adequate, albeit realistic, levels of utilization, the statistical difference in service intensity may not be great enough to drive larger differences in clinical outcomes.…”

Section: Discussionmentioning

confidence: 99%

PRISM-E: Comparison of Integrated Care and Enhanced Specialty Referral Models in Depression Outcomes

Krahn¹,

Bartels²,

Coakley³

et al. 2006

Psychiatric Services

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“…For example, investigators report reducing barriers to timely consultations (Detweiler et al, 2011(Detweiler et al, , 2012 and increasing guideline-adherent treatment for depression (Watts et al, 2007). Although evidence suggests these systems may increase behavioral health costs (Domino et al, 2008), such cost impacts are not being seen in telemedicine (Fortney, Maciejewski, Tripathi, Deen, & Pyne, 2011). Implementation research indicates that sustaining integrated mental health care in primary care is likely to be most effective when clinical and administrative champions lead the culture change, in outcome oriented cultures, with interdisciplinary training and accountability systems to provide feedback to providers (Kathol, Butler, McAlpine, & Kane, 2010).…”

Section: Factors That Influence Military Service Member and Veteran R...mentioning

confidence: 99%

Military service member and veteran reintegration: A critical review and adapted ecological model.

Elnitsky

Blevins

Fisher

et al. 2017

American Journal of Orthopsychiatry

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Returning military service members and veterans (MSMVs) experience a wide range of stress-related disorders in addition to social and occupational difficulties when reintegrating to the community. Facilitating reintegration of MSMVs following deployment is a societal priority. With an objective of identifying challenges and facilitators for reintegration of MSMVs of the current war era, we critically review and identify gaps in the literature. We searched 8 electronic databases and identified 1,764 articles. Screening of abstracts and full-text review based on our inclusion/exclusion criteria, yielded 186 articles for review. Two investigators evaluating relevant articles independently found a lack of clear definition or comprehensive theorizing about MSMV reintegration. To address these gaps, we linked the findings from the literature to provide a unified definition of reintegration and adapted the social ecological systems theory to guide research and practice aimed at MSMV reintegration. Furthermore, we identified individual, interpersonal, community, and societal challenges related to reintegration. The 186 studies published from 2001 (the start of the current war era) to 2015 included 6 experimental studies or clinical trials. Most studies do not adequately account for context or more than a narrow set of potential influences on MSMV reintegration. Little evidence was found that evaluated interventions for health conditions, rehabilitation, and employment, or effective models of integrated delivery systems. We recommend an ecological model of MSMV reintegration to advance research and practice processes and outcomes at 4 levels (individual, interpersonal, organizational, and societal). (PsycINFO Database Record

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“…An increasing body of evidence indicates that collaborative care models (CCMs) for depression are feasible, sustainable, effective for both shortterm and long-term outcomes, and cost-effective (Katon et al, 2005;Rost et al, 2005;Gilbody et al, 2006;Domino et al, 2008;Chang-Quan et al, 2010;Chaney et al, 2011). In one variation, a non-physician care manager provides administrative coherence to primary care providers in assessing and treating patients with depression, often with the involvement of collaborating mental health specialists.…”

Section: Introductionmentioning

confidence: 99%

Integration of geriatric mental health screening into a primary care practice: a patient satisfaction survey

Samuels

Abrams

Shengelia

et al. 2014

Int J Geriat Psychiatry

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Objective Colocation of mental health screening, assessment, and treatment in primary care reduces stigma, improves access, and increases coordination of care between mental health and primary care providers. However, little information exists regarding older adults’ attitudes about screening for mental health problems in primary care. The objective of this study was to evaluate older primary care patients’ acceptance of and satisfaction with screening for depression and anxiety. Methods The study was conducted at an urban, academically affiliated primary care practice serving older adults. Study patients (N = 107) were screened for depression/anxiety and underwent a post-screening survey/interview to assess their reactions to the screening experience. Results Most patients (88.6%) found the length of the screening to be “just right.” A majority found the screening questions somewhat or very acceptable (73.4%) and not at all difficult (81.9%). Most participants did not find the questions stressful (84.9%) or intrusive (91.5%); and a majority were not at all embarrassed (93.4%), upset (93.4%), or uncomfortable (88.8%) during the screening process. When asked about frequency of screening, most patients (72.4%) desired screening for depression/anxiety yearly or more. Of the 79 patients who had spoken with their physicians about mental health during the visit, 89.8% reported that it was easy or very easy to talk with their physicians about depression/anxiety. Multivariate results showed that patients with higher anxiety had a lower positive reaction to the screen when controlling for gender, age, and patient–physician communication. Conclusions These results demonstrate strong patient support for depression and anxiety screening in primary care.

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The Influence of Integration on the Expenditures and Costs of Mental Health and Substance Use Care: Results from the Randomized PRISM-E Study

Cited by 10 publications

References 42 publications

PRISM-E: Comparison of Integrated Care and Enhanced Specialty Referral Models in Depression Outcomes

PRISM-E: Comparison of Integrated Care and Enhanced Specialty Referral Models in Depression Outcomes

Military service member and veteran reintegration: A critical review and adapted ecological model.

Integration of geriatric mental health screening into a primary care practice: a patient satisfaction survey

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