Five-Year Mental Health Care Use by Patients Referred to Collaborative Care or to Specialized Care

Publication Type:

Journal Article

Source:

Psychiatric Services, Volume 66, p.840-844 (2015)

Other Number:

10.1176/appi.ps.20140023

Keywords:

collaborative care; specialized care; prospective; health care use

Abstract:

This study compared
long-term use of mental health care by two groups of patients who had common
mental disorders in the Netherlands-those treated in a collaborative care
setting and those referred to off-site specialized mental health services if
indicated. METHODS: The study was a retrospective analysis of use of mental
health care over five years by 139 patients who participated in a cluster-randomized
parent study. The parent study involved 27 general practitioners (GPs) who
provided either collaborative care or usual care. In the collaborative care
condition, a mental health professional worked on site at the GP's practice and
was available to provide short-term treatment. In the usual-care condition, the
GP referred the patient to off-site specialized mental health services if
indicated; if not indicated, the GP provided usual care. The two treatment
groups were compared on the number of mental health care contacts and total
treatment duration, the proportion that initiated a new treatment episode after
termination of the initial treatment, and time to new treatment. RESULTS:
Patients in the collaborative care condition received about half the number of
mental health care contacts as those in the usual-care condition, and no
differences were found in the rate of initiation of new treatment episodes
after initial treatment, time to new treatment, and total treatment duration.
CONCLUSIONS: Referral of patients with common mental disorders to collaborative
mental health care as a first intervention led to fewer contacts with a mental
health care professional over the long term, compared with referral to
specialized mental health care.