Patients Face Fragmentation

Despite research showing improved outcomes with access to primary care and mental health professionals, people with mental illness rarely see both for care.


FOR IMMEDIATE RELEASE - Wednesday, May 14, 2014

Contact: 
Leslie Champlin
Senior Public Relations Strategist
(800) 274-2237, Ext. 5224
lchampli@aafp.org 

WASHINGTON, DC — Patients suffering depression, anxiety or other mental health conditions face a gaping hole in services, but that gap can be closed by integrating primary care and mental health professionals. That’s the conclusion of “Mental Health Treatment in the Primary Care Setting: Patterns and Pathways,” published in the May issue of Family Systems and Health.

Research has demonstrated the strong link between physical and mental health. A deterioration or improvement in one area affects the other. That means access to both primary care and mental health professionals is essential to comprehensive, patient-focused care, according to researcher Stephen Petterson, PhD, research director at the Robert Graham Center for Policy Studies in Family Medicine and Primary care, and his coauthors. 

However, fragmented services challenge patients’ ability to get comprehensive care, according to their findings. 

“Ideally, we would integrate mental health and primary care services for patients,” Petterson said. “But what we’re seeing is a lot of people with poor mental health going through the primary care system and low rates of shared care between primary care and mental health professionals.”

Petterson and his coauthors reviewed data from the Medical Expenditure Panel Survey and results from in-person interviews with 109,593 adults who accounted for 184,636 patient visits. They found that 8 percent had poor mental health. Of those, nearly half got all their care only from primary care physicians, 5 percent obtained care exclusively from a mental health professional, and only 14 percent received care from both mental health and primary care professionals.

Among adults who reported having a mental health visit, 35 percent saw only their primary care professional for psychological and physical care, 43 percent saw a mental health provider exclusively, and 8 percent saw both a primary care and mental health professional. People who had serious mental health conditions such as schizophrenia or adjustment disorders were more likely to see mental health professionals exclusively.

The challenge — given the close link between physical and mental health — is to increase the number of people who get care from both the primary care and behavioral health professionals, who can work together to ensure optimal physical and psychological health.

“As our data suggest, persons seeking treatment for mental health conditions often do not combine care from primary care and mental health providers,” the researchers write. “Integrating mental health professionals into primary care could reach a significant portion of the population with mental health needs and further the ability for behavioral health and primary care providers to collaborate.”

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About the Robert Graham Center

The Robert Graham Center for Policy Studies in Family Medicine and Primary Care works to improve individual and population health by enhancing the delivery of primary care. The Center staff generates and analyzes evidence that brings a family medicine and primary care perspective to health policy deliberations at local, state, and national levels.

Founded in 1999, the Robert Graham Center is an independent research unit affiliated with the American Academy of Family Physicians (AAFP). The information and opinions contained in research from the Center do not necessarily reflect the views or policy of the AAFP.