One of the largest studies of its kind finds that care teams comprised of mental health and primary care providers improve outcomes and reduce costs. ER visits were seen to drop 23% for patients in team-based practices.
Integrating mental health into primary care settings improves patients' clinical outcomes, lowers healthcare utilization, and decreases costs, according to a large 10-year study from Salt Lake City-based Intermountain Healthcare.
The study, published this month in the Journal of the American Medical Association, measured 113,452 adult patients who received care from 2003 through 2013 in 113 primary care practices at Intermountain. Care was provided by 27 team-based medical practices and 75 traditional practices.
At the team-based practices, mental health staff, including psychiatrists, psychologists, psychiatric advanced practice registered nurses, social workers, and others, are available on site to support primary care physicians.
Mental Health Programs Gaining Momentum
"The intention is not to co-locate a mental health provider at a location and have patients coming there specifically for mental health," Jeremy Hernandez, regional assistant operations officer for the North Salt Lake region of Intermountain Medical Group, told HealthLeaders previously.
"Instead the intention is to integrate the mental health provider into the primary care team where patients can have their medical and mental health needs met at the same location."
While the value of integrated team delivery models was not previously well quantified, Intermountain researchers found the following:
- Thanks to higher screening levels, 46.1% of patients in team-based practices were diagnosed with active depression compared to 24.1% in traditional practices.
- Nearly half (48.4%) of patients in team-based practices had a documented self-care plan to help them manage their health conditions, compared to just 8.7% in traditional practices.
- Per 100 person years, the rate of emergency room visits dropped 23%, from 23.5 visits for patients in traditional practices to 18.1 for patients in team-based practices.
Access to Mental Health Services Still Lags
"The study reinforces the value of coordinated team relationships within a delivery system and the importance of integrating physical and mental health care," Intermountain Healthcare scientist Brenda Reiss-Brennan, PhD, APRN, one of the study's authors, said in a news release.
"The study provides further evidence—from a mental health perspective—of Intermountain Healthcare's hypothesis that better care costs less," she added.