Are primary care mental health services associated with differences in specialty mental health clinic use?

Objectives: The aim of this study was to determine whether implementation of primary care mental health services is associated with differences in specialty mental health clinic use within the Veterans Health Administration (VHA).

Methods: The authors compared over a one-year period the new use of specialty mental health clinics and psychiatric diagnosis patterns among patients of 118 primary care facilities that offered integrated mental health care with 142 facilities without this service, with adjustment for other facility characteristics.

Results: Patients at both types of primary care facilities (those with integrated mental health care and those without) initiated specialty mental health treatment at similar rates (5.6% versus 5.8%) and averaged similar total specialty mental health clinic visits (7.0 versus 6.3). There were no significant differences in diagnosis patterns.

Conclusions: Initial national implementation of mental health care in primary care within the VHA was not associated with substantial differences in new specialty mental health clinic use or diagnostic case mix among primary care patients.