Navigation Links
'1-stop' clinic ups mental health, social work visits for veterans
Date:6/10/2011

Iraq and Afghanistan veterans who visited a VA integrated care clinic were much more likely to undergo initial mental health and social work evaluations than veterans who visited a standard VA primary care clinic, according to a study led by a San Francisco VA Medical Center researcher.

The increase was especially significant for women veterans, younger veterans, veterans with mental health diagnoses, and veterans who screened positive for traumatic brain injury.

The study was published on June 7, 2011 in the electronic Online First section of the Journal of General Internal Medicine.

The decisive factor was the integrated care model, itself, said the lead author of the study, Karen Seal, MD, MPH, co-founder and co-director of the Integrated Care Clinic at the San Francisco VA Medical Center, which was the site of the study.

Under the conventional VA model, patients are seen by a primary care physician and, if they screen positive for mental illness according to the VA's standard protocol, are referred to a mental health provider. That referral appointment would not necessarily be available the same day, nor in the same clinic.

Under the integrated care model, all patients are referred immediately by their primary care physician to a mental health provider, called the "Post-Deployment Stress Specialist," and a social worker, called the "Combat Case Manager." All visits take place during the same appointment, in the same clinic, with no waiting.

"This demonstrates the value of the integrated care clinic model for our veterans, especially those who may be more vulnerable," said Seal, who is also an associate professor in residence of medicine and psychiatry at the University of California, San Francisco.

The study also showed, however, that the rate of follow-up mental health care the number of subsequent visits with mental health providers that took place after initial evaluation was not any higher under the integrated care model than under standard care.

"We are really good at initial engagement, but unfortunately, we are not as successful at helping veterans stay with and complete a course of mental health treatment," said Seal. "We need to learn how to help veterans stick with the more difficult first few sessions of PTSD treatment, so they can get through to the other side when they really start to feel better." Seal explained that successful PTSD treatment usually takes nine to 12 sessions.

The study examined the medical records of 526 Iraq and Afghanistan veterans who came to SFVAMC between 2005 and 2009 for their first primary care visit after returning from combat deployment. Veterans who visited after April 1, 2007 the date that the Integrated Care Clinic was founded were given an appointment at either the Integrated Care Clinic or a conventional care clinic.

The 30-day mental health evaluation rate was 92 percent for the integrated care patients versus 59 percent for standard care patients. The rate for social work evaluation was 77 percent versus 56 percent.

For women veterans, the rate of initial mental health evaluations in integrated care was three times the conventional care rate. "This is good news, because women veterans have a high burden of mental health problems, and, at the same time, a disproportionate number of barriers to care, such as child care issues and other logistical constraints," said Seal.

Seal noted that the overall rate of initial mental health evaluations was higher in the integrated care model even after allowing for an overall VA systemwide improvement in first-time mental health evaluations that occurred after 2007.

She speculated that one promising approach to helping veterans complete their course of PTSD treatment might be the VA Patient Aligned Care Team (PACT) model, a new team-based method of providing primary care in the VA system. "One member of the patient care team could be assigned to make reminder phone calls for example, to encourage veterans to stick with and complete their mental health treatment," Seal said.


'/>"/>

Contact: Steve Tokar
steve.tokar@ncire.org
415-221-4810 x5202
University of California - San Francisco
Source:Eurekalert

Related medicine news :

1. Bone cancer, from the lab to the clinic
2. Universal flu vaccine clinical trials show promise
3. Mayo Clinic: Flaxseed no cure for hot flashes during breast cancer or menopause
4. Pioneering stem cell bandage receives approval for clinical trial
5. Fighting cancer with cancer: Mayo Clinic finds promising use for thyroid cancer gene
6. Mayo Clinic, NCCTG find no tie between PTEN and response to breast cancer drug
7. Mayo Clinic: Raoul Tibes, M.D., Ph.D., to receive Career Development Award
8. In the lab and clinic, VCU Massey develops a new therapy for blood cancers
9. Mayo Clinic finds discussion of end-of-life care helps heart to patients and families
10. Private weight-loss surgery clinics shedding quality patient care
11. NIH grant for the move toward clinical trials targeting the lysosomal storage disease MPSIIIB
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:6/26/2016)... ... June 26, 2016 , ... Brent Kasmer, a legally blind and certified personal trainer is ... a fitness app. The fitness app plans to fix the two major problems leading the ... one size fits all type program , They don’t eliminate all the reasons ...
(Date:6/25/2016)... ... June 25, 2016 , ... Experts from the American ... Annual Research Meeting June 26-28, 2016, at the Hynes Convention Center in Boston. ... including advance care planning, healthcare costs and patient and family engagement. , AIR ...
(Date:6/25/2016)... ... ... of Bruton Memorial Library on June 21 due to a possible lice infestation, as reported ... head lice: the parasite’s ability to live away from a human host, and to infest ... in the event that lice have simply gotten out of control. , As lice are ...
(Date:6/25/2016)... ... 25, 2016 , ... First Choice Emergency Room , the largest network ... the Medical Director of its new Mesquite-Samuell Farm facility. , “We are pleased ... location,” said Dr. James M. Muzzarelli, Executive Medical Director of First Choice Emergency Room. ...
(Date:6/25/2016)... ... June 25, 2016 , ... ... non-athletes recover from injury. Recently, he has implemented orthobiologic procedures as a method ... —Johnson is one of the first doctors to perform the treatment. Orthobiologics are ...
Breaking Medicine News(10 mins):
(Date:6/24/2016)... Calif. , June 24, 2016  Global ... a biopharmaceutical company developing novel therapeutics for the ... needs, today announced the closing of its previously ... common stock, at the public offering price of ... the offering were offered by GBT. GBT estimates ...
(Date:6/24/2016)... DUBLIN , June 24, 2016 ... and Markets has announced the addition of the ... their offering. ... products and provides an updated review, including its applications ... covering the total market, which includes three main industries: ...
(Date:6/24/2016)... -- The Academy of Managed Care Pharmacy (AMCP) today ... allow biopharmaceutical companies to more easily share health care ... coverage decisions, a move that addresses the growing need ... The recommendations address restrictions in the sharing of product ... a prohibition that hinders decision makers from accessing HCEI ...
Breaking Medicine Technology: