Association Between Mental Health Staffing Level and Primary Care-Mental Health Integration Level on Provision of Depression Care in Veteran's Affairs Medical Facilities

Adm Policy Ment Health. 2018 Jan;45(1):131-141. doi: 10.1007/s10488-016-0775-9.

Abstract

We examined the association of mental health staffing and the utilization of primary care/mental health integration (PCMHI) with facility-level variations in adequacy of psychotherapy and antidepressants received by Veterans with new, recurrent, and chronic depression. Greater likelihood of adequate psychotherapy was associated with increased (1) PCMHI utilization by recurrent depression patients (AOR 1.02; 95% CI 1.00, 1.03); and (2) staffing for recurrent (AOR 1.03; 95% CI 1.01, 1.06) and chronic (AOR 1.02; 95% CI 1.00, 1.03) depression patients (p < 0.05). No effects were found for antidepressants. Mental health staffing and PCMHI utilization explained only a small amount of the variance in the adequacy of depression care.

Keywords: Antidepressants; Depression; Integrated care; Psychotherapy; Staffing.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Antidepressive Agents / therapeutic use*
  • Depressive Disorder / therapy*
  • Female
  • Health Services Accessibility
  • Humans
  • Male
  • Mental Health Services / organization & administration*
  • Middle Aged
  • Odds Ratio
  • Personnel Staffing and Scheduling / statistics & numerical data*
  • Primary Health Care / organization & administration*
  • Psychotherapy / statistics & numerical data*
  • Quality of Health Care
  • United States
  • United States Department of Veterans Affairs

Substances

  • Antidepressive Agents