The DOI matches its Crossref record; 24 of the 24 references it cites were found in a registry or an index.
Improving Access to Geriatric Mental Health Services: A Randomized Trial Comparing Treatment Engagement With Integrated Versus Enhanced Referral Care for Depression, Anxiety, and At-Risk Alcohol Use
Abstract
OBJECTIVE: The authors sought to determine whether integrated mental health services or enhanced referral to specialty mental health clinics results in greater engagement in mental health/substance abuse services by older primary care patients. METHOD: This multisite randomized trial included 10 sites consisting of primary care and specialty mental health/substance abuse clinics. Primary care patients 65 years old or older (N=24,930) were screened. The final study group consisted of 2,022 patients (mean age=73.5 years; 26% female; 48% ethnic minority) with depression (N=1,390), anxiety (N=70), at-risk alcohol use (N=414), or dual diagnosis (N=148) who were randomly assigned to integrated care (mental health and substance abuse providers co-located in primary care; N=999) or enhanced referral to specialty mental health/substance abuse clinics (i.e., facilitated scheduling, transportation, payment; N=1,023). RESULTS: Seventy-one percent of patients engaged in treatment in the integrated model compared with 49% in the enhanced referral model. Integrated care was associated with more mental health and substance abuse visits per patient (mean=3.04) relative to enhanced referral (mean=1.91). Overall, greater engagement was predicted by integrated care and higher mental distress. For depression, greater engagement was predicted by integrated care and more severe depression. For at-risk alcohol users, greater engagement was predicted by integrated care and more severe problem drinking. For all conditions, greater engagement was associated with closer proximity of mental health/substance abuse services to primary care. CONCLUSIONS: Older primary care patients are more likely to accept collaborative mental health treatment within primary care than in mental health/substance abuse clinics. These results suggest that integrated service arrangements improve access to mental health and substance abuse services for older adults who underuse these services.
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“Because older adults are reluctant to seek care in mental health clinics or providers' offices, however, interventions delivered in primary care are likely to be more effective (59).”
From Suicide in older adults (2011) · cites this paper as [59]
In the citing paper
“Because older adults are reluctant to seek care in mental health clinics or providers' offices, however, interventions delivered in primary care are likely to be more effective (59).”
From Suicide in older adults (2011) · cites this paper as [59]
Citations
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Cited by
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Fiske, A., Wetherell, J. L., & Gatz, M. (2009) · Annual Review of Clinical Psychology · doi:10.1146/annurev.clinpsy.032408.153621 · Cited by 2,353
Collaborative care for depression and anxiety problems
Archer, J., Bower, P., Gilbody, S., Lovell, K., Richards, D., Gask, L., Dickens, C., & Coventry, P. (2012) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd006525.pub2 · Cited by 1,126
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Substance Abuse Among Older Adults
Kuerbis, A., Sacco, P., Blazer, D. G., & Moore, A. A. (2014) · Clinics in Geriatric Medicine · doi:10.1016/j.cger.2014.04.008 · Cited by 505
The Mental Health and Substance Use Workforce for Older Adults: In Whose Hands?
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Metadata
- Authors
- Bartels, S. J., Coakley, E. H., Zubritsky, C., Ware, J. H., Miles, K. M., Areán, P. A., Chen, H., Oslin, D. W., Llorente, M. D., Costantino, G., Quijano, L., McIntyre, J. S., Linkins, K. W., Oxman, T. E., Maxwell, J., Levkoff, S. E., & PRISM-E Investigators
- Affiliations
- Dartmouth College (US)
- Venue
- American Journal of Psychiatry
- Published
- 2004-08-01
- Volume
- 161
- Issue
- 8
- Pages
- 1455-1462
- ISSN
- 0002-953X (ISSN-L)
- 1535-7228
- OpenAlex
- W2157253072
- Cited by
- 417
- References
- 23
- Citations by year
- 2026: 5 · 2025: 5 · 2024: 15 · 2023: 6 · 2022: 14 · 2021: 13 · 2020: 16 · 2019: 13 · 2018: 18 · 2017: 16 · 2016: 19 · 2015: 35 · 2014: 28 · 2013: 23 · 2012: 23
- FWCI
- 29.67
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Funders
- U.S. Department of Health and Human Services
- Australian Government
- Centers for Medicare and Medicaid Services
- Center for Substance Abuse Treatment
- Center for Mental Health Services
- Center for Substance Abuse Prevention
- 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 › Epidemiology › Substance Abuse Treatment and Outcomes
- Keywords
- integrated care, geriatric mental health services, treatment engagement, older adults, depression, anxiety, at-risk alcohol use, dual diagnosis, substance abuse, primary care, access to mental health care
- MeSH terms
- Age Factors, Aged, Alcohol Drinking, Anxiety Disorders, Community Mental Health Centers, Depressive Disorder, Major, Major Depressive Disorder, Depressive Disorder, Female, Health Services Accessibility, Health Services for the Aged, Health Services Misuse, Humans, Male, Primary Health Care, Referral and Consultation, Severity of Illness Index, Substance Abuse Treatment Centers, Treatment Outcome, Delivery of Health Care, Integrated
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