Effectiveness of telephone-based referral care management, a brief intervention to improve psychiatric treatment engagement

Psychiatr Serv. 2008 Jul;59(7):776-81. doi: 10.1176/ps.2008.59.7.776.


Objective: This study examined the effectiveness of a telephone-based referral care management (TBR-CM) intervention for improving engagement in psychiatric treatment.

Methods: From September 2005 to May 2006, 169 primary care patients at the Philadelphia Veterans Affairs Medical Center completed a psychiatric diagnostic interview and were identified as needing psychiatric care. From this total of eligible patients, 113 (67%) gave informed consent and were randomly assigned to receive either usual care or the intervention. Usual care consisted of participants' being schedule for a behavioral health care appointment, followed by a letter and reminder by telephone. The intervention group received the same, plus one or two brief motivational telephone sessions. Participant interviews and medical records provided study data.

Results: Research participants were primarily African American and 22-83 years old. In the sample, 40 patients (39%) had severe depression, 40 (39%) had substance use problems, and 33 (22%) had co-occurring severe depression and substance abuse. Overall, 40 participants (70%) in the intervention group compared with 18 (32%) in the usual care group engaged in at least one psychiatric treatment appointment (p<.001). Analyses also indicated that on average the intervention group attended more appointments (more than three) compared with the usual care group (less than two) (p=.008).

Conclusions: The TBR-CM intervention program was effective at improving psychiatric treatment engagement. Future research is necessary to examine effectiveness of TBR-CM in more heterogeneous and larger samples and to evaluate economic benefits versus costs of intervention delivery.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Depressive Disorder / psychology
  • Depressive Disorder / therapy*
  • Humans
  • Male
  • Middle Aged
  • Philadelphia
  • Primary Health Care / methods*
  • Referral and Consultation*
  • Substance-Related Disorders / psychology
  • Substance-Related Disorders / therapy*
  • Telephone*
  • Treatment Outcome
  • Veterans / statistics & numerical data