Cited by 231Mental Health Treatment and AccessPsychiatric care and mental health servicesPrimary Care and Health Outcomes

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Closing the False Divide: Sustainable Approaches to Integrating Mental Health Services into Primary Care

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Kroenke, Kurt, Unutzer, Jurgen·2017·Journal of General Internal Medicine

DOI 10.1007/s11606-016-3967-9PMC PMC5377893

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Abstract

Mental disorders account for 25% of all health-related disability worldwide. More patients receive treatment for mental disorders in the primary care sector than in the mental health specialty setting. However, brief visits, inadequate reimbursement, deficits in primary care provider (PCP) training, and competing demands often limit the capacity of the PCP to produce optimal outcomes in patients with common mental disorders. More than 80 randomized trials have shown the benefits of collaborative care (CC) models for improving outcomes of patients with depression and anxiety. Six key components of CC include a population-based approach, measurement-based care, treatment to target strategy, care management, supervision by a mental health professional (MHP), and brief psychological therapies. Multiple trials have also shown that CC for depression is equally or more cost-effective than many of the current treatments for medical disorders. Factors that may facilitate the implementation of CC include a more favorable alignment of medical and mental health services in accountable care organizations and patient-centered medical homes; greater use of telecare as well as automated outcome monitoring; identification of patients who might benefit most from CC; and systematic training of both PCPs and MHPs in integrated team-based care.

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Self-citation

Authors: Kroenke, K., & Unutzer, J.
Affiliations: Regenstrief Institute (US)
Corresponding author: Kroenke, Kurt
ORCID: Kroenke, Kurt
Venue: Journal of General Internal Medicine
Publisher: Springer Science and Business Media LLC
Published: 2017-02-27
Volume: 32
Issue: 4
Pages: 404-410
ISSN: 0884-8734 (ISSN-L)
1525-1497
DOI: 10.1007/s11606-016-3967-9
PMC: PMC5377893
OpenAlex: W2591581327
Cited by: 231
References: 61
Citations by year: 2026: 17 · 2025: 13 · 2024: 19 · 2023: 31 · 2022: 32 · 2021: 53 · 2020: 23 · 2019: 16 · 2018: 15 · 2017: 12
FWCI: 25.83
Type: journal article
Language: en
Open access: hybrid
doi.org
Licence: cc-by
creativecommons.org/licenses/by/4.0 (unspecified)
Locations: Journal of General Internal Medicine (publishedVersion, cc-by)
PubMed Central (publishedVersion, cc-by)
PubMed (publishedVersion)
IUScholarWorks (Indiana University) (submittedVersion, cc-by)
PMC
Funders: California Health Care Foundation
Society of General Internal Medicine
University of California, Davis
Topics: Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
Health Sciences › Medicine › Family Practice › Primary Care and Health Outcomes
Keywords: integrated mental health services, primary care, collaborative care, depression, anxiety, common mental disorders, measurement-based care, treat-to-target, care management, cost-effectiveness, accountable care organizations, patient-centered medical home, telecare, team-based care, implementation barriers
MeSH terms: Mental Disorders, Cost-Benefit Analysis, Humans, Mental Health Services, Primary Health Care, Models, Organizational, Delivery of Health Care, Integrated, Vulnerable Populations

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Closing the False Divide: Sustainable Approaches to Integrating Mental Health Services into Primary Care

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