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Cited by 84Mental Health Treatment and AccessPsychiatric care and mental health servicesHealthcare Systems and Technology

Collaborative Mental Health Care Versus Care as Usual in a Primary Care Setting: A Randomized Controlled Trial

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van Orden, Mirjam, Hoffman, Tonko, Haffmans, Judith, Spinhoven, Philip, Hoencamp, Erik·2009·Psychiatric Services
DOI 10.1176/ps.2009.60.1.74
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Abstract

OBJECTIVE: This study compared the effectiveness of treating common mental disorders in a collaborative care program in a primary care setting and the effectiveness of treating such disorders through traditional referral of patients to mental health services. METHODS: In a cluster randomized controlled trial, 27 general practitioner practices in the Netherlands were designated to provide either collaborative care or usual care. In the collaborative care condition, a mental health care professional worked on site at the primary care practice and was available to provide patients a maximum of five appointments if they were referred by the general practitioner. If indicated, referral to specialized mental health services followed. In the usual care condition, if indicated, general practitioners would refer patients to off-site specialized mental health services. The study included 165 patients. At baseline and at three, six, and 12 months, the study assessed patients' psychopathology, patients' quality of life, and patients' and general practitioners' satisfaction with the treatment provided. Delay in seeing a mental health provider, duration of treatment, number of appointments, and related treatment costs were assessed at 12 months. The data were analyzed with hierarchical linear models. RESULTS: Level of patients' psychopathology and quality of life significantly improved over time, and there were no significant differences between models of care. There was no significant difference in patients' satisfaction with care in either condition. The collaborative care condition resulted in significantly higher satisfaction with services among general practitioners, shorter referral delay, reduced time in treatment, fewer appointments, and consequently lower treatment costs. CONCLUSIONS: Collaborative care for a heterogeneous group of persons with common mental disorders seems to be as effective as the usual practice of referral to mental health services for reducing psychopathology, but it is significantly more efficient regarding referral delay, duration of treatment, number of appointments, and related treatment costs.

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  • The two studies found showed fewer GP contacts after short-term psychological interventions and higher satisfaction among GPs.

    “The two studies we found [18,19] showed fewer GP contacts after short-term psychological interventions and higher satisfaction among GPs.”

    From Healthcare utilization in general practice before and after psychological treatment: A follow-up data linkage study in primary care (2014) · cites this paper as [19]

    The Results (Table 3, p. 78) report significantly higher GP satisfaction with collaborative care, and the Interventions section describes a brief psychological intervention. The Discussion (p. 78) reports fewer contacts with mental health organizations, not fewer patient contacts with GPs; this paper also cannot establish what both cited studies found. (LLM, conf=0.88)

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Authors
van Orden, M., Hoffman, T., Haffmans, J., Spinhoven, P., & Hoencamp, E.
Affiliations
Leiden University (NL)
ORCID
Spinhoven, Philip
Venue
Psychiatric Services
Publisher
American Psychiatric Association Publishing
Published
2009-01
Volume
60
Issue
1
Pages
74-79
ISSN
  • 0022-1597 (ISSN-L)
  • 1075-2730
  • 1557-9700
DOI
10.1176/ps.2009.60.1.74
OpenAlex
W2168553388
Cited by
84
References
27
Citations by year
2024: 2 · 2023: 6 · 2022: 3 · 2021: 1 · 2020: 8 · 2019: 4 · 2018: 5 · 2017: 7 · 2016: 3 · 2015: 11 · 2014: 6 · 2013: 8 · 2012: 5
FWCI
8.67
Type
journal article
Language
en
Open access
Locations
  • Psychiatric Services (publishedVersion)
  • PubMed (publishedVersion)
  • Leiden Repository (Leiden University) (submittedVersion)
  • Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
Topics
  • Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
  • Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
  • Social Sciences › Business, Management and Accounting › Organizational Behavior and Human Resource Management › Healthcare Systems and Technology
Keywords
collaborative care, common mental disorders, primary care, psychiatric referral, psychopathology, quality of life, patient satisfaction, general practitioner satisfaction, late referral, treatment duration, treatment costs, integrated care
MeSH terms
Adult, Cooperative Behavior, Family Practice, Female, Humans, Male, Mental Health Services, Middle Aged, Netherlands, Referral and Consultation, Cluster Analysis, Patient Satisfaction, Outcome Assessment, Health Care, Efficiency, Organizational, Young Adult

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