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Referral and Engagement Rates

There is rich evidence regarding the improvement  of referral and engagement rates when integrated care is provided.

  • When a multidisciplinary mental team worked in collaboration with primary care doctors in a VA facility to evaluate and treat clients, referrals to specialty mental health dropped from 38% to 14%, suggesting that this intervention could lessen the need for specialty mental health services. The average number of appointments for evaluation and treatment with the team was 2.5.
    • Bradford Felker et al., “Preliminary Outcomes from an Integrated Mental Health Primary CareTeam”, Psychiatric Services, 2004, 55.
  • A total of 71% elderly clients assigned to integrated care engaged in treatment, compared to just 49% of the group who received outside referrals.
    • Stephen Bartels et al., American Journal of Psychiatry, 2004, 161(8).
  • Sixty-one percent of all primary care clients surveyed and 69% of depressed clients desired counseling, but relatively few desired a referral to a mental health specialist.
    • D. Brody et al., “Patients’ perspectives on the management of emotional distress in primary care settings”, Gen Internal Medicine, 1997, Jul 12 (7).
  • In cases where the primary care physicians personally introduced their clients to a behavioral health specialist during the clients’ medical visit, 76% subsequently kept a first appointment with the specialists. If the physicians simply scheduled an appointment without a personal introduction, only 44% of the clients kept the first appointment.
    • N. Apostoleris, “Integrating psychological services into primary care in an underserved community: examining the referral process for on-site mental health services”, 2000 presentation, as referenced by Alexander Blount.
  • Primary care clients with minor depression who received were randomly assigned to an eight-week cognitive behavioral intervention missed fewer appointments with their primary care provider during the following year than did a similar group who received no intervention.
    • J. Miranda, Intervention for minor depression in primary care patients, Psychosomatic Medicine, 1994, Vol 56, Issue 2.
  • A phone survey of 6,586 primary care physicians found that 54% reported problems obtaining psychiatric hospital admissions and arranging outpatient mental health referrals.
    • S. Turde et al., “Referral Gridlock” Primary Care Physicians and Mental Health Services”Journal of General Internal Medicine, 2003 18 (6)