Age group differences among veterans enrolled in a clinical service for behavioral health issues in primary care

Am J Geriatr Psychiatry. 2012 Mar;20(3):205-14. doi: 10.1097/JGP.0b013e3181ec828a.


Objectives: : To examine age group differences in the identification, engagement, clinical outcomes, and monitoring of older, relative to middle aged and younger, veterans with behavioral health needs enrolled in an integrated care management program

Design: : Cross-sectional and longitudinal

Setting: : Primary care clinics affiliated with two Veterans Affairs Medical Centers

Participants: : A total of 9,087 veterans were referred to the Behavioral Health Laboratory (BHL) for a behavioral health assessment and 7,251 completed an initial assessment

Measurements: : Data on consult source and reason for the referral, clinical assessment outcomes, and engagement were collected during a 3-year period. Variations in process and patient-level factors were examined as a function of age group.

Results: : Although all age groups evidenced high rates of engagement in clinical assessment calls, older adults were slightly more likely to complete the assessments than young/middle-aged veterans. Clinical assessment outcomes revealed that although older adults were less likely to meet criteria for more complex, severe conditions, rates of disorder remained clinically significant, and comorbidity was common. Finally, older veterans receiving treatment monitoring for a newly prescribed antide- pressant consistently reported high rates of antidepressant adherence during the course of the monitoring calls and showed significant reductions in depressive symptomatology during the course of monitoring.

Conclusions: : Results indicate age-related variability in processes and outcomes among veterans referred to the BHL and suggest that older veterans are just as likely to benefit from a program designed to facilitate the identification, engagement, monitoring, and care management of primary care patients experiencing behavioral health issues.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Chi-Square Distribution
  • Cross-Sectional Studies
  • Depression / diagnosis
  • Depression / therapy
  • Female
  • Humans
  • Interview, Psychological
  • Longitudinal Studies
  • Male
  • Mental Disorders / diagnosis
  • Mental Disorders / therapy*
  • Middle Aged
  • Primary Health Care / statistics & numerical data
  • Psychiatric Status Rating Scales
  • Referral and Consultation / statistics & numerical data
  • Risk Factors
  • United States
  • United States Department of Veterans Affairs / statistics & numerical data
  • Veterans / psychology*
  • Veterans / statistics & numerical data