Quality of Mental Health Care in Integrated Veterans Affairs Patient-Centered Medical Homes: a National Observational Study

Excerpt

Mental health integration in primary care is effective but challenging to disseminate and implement in health care systems.¹ Over the past decade, the Veterans Health Administration (VA) transformed primary care practices nationally into team-based care models: Primary Care–Mental Health Integration (PC-MHI)² (i.e., evidence-based collaborative care) in 2007 and Patient Aligned Care Teams (PACT)³ (i.e., patient-centered medical home) in 2010. Both initiatives provide staffing and resources to support primary care providers, care managers, and integrated mental health specialists in jointly treating low-to-moderate severity psychiatric conditions within primary care.² Primary care has been tasked with universal mental health screening and expected to initiate timely treatment, aided by PC-MHI, for Veterans identified with needs. As such, mental health care has accordingly shifted from VA specialty to PACT/primary care settings.⁴ This study examined whether increasing penetration of PC-MHI services among PACT clinics was associated with improved mental health care process quality measures for VA primary care patients. …