Integration of mental health resources in a primary care setting leads to increased provider satisfaction and patient access

Gen Hosp Psychiatry. 2013 Sep-Oct;35(5):461-7. doi: 10.1016/j.genhosppsych.2013.06.011. Epub 2013 Jul 30.


Objective: This evaluation assessed the opinions and experiences of primary care providers and their support staff before and after implementation of expanded on-site mental health services and related system changes in a primary care clinic.

Method: Individual semistructured interviews, which contained a combination of open-ended questions and rating scales, were used to elicit opinions about mental health services before on-site system and resource changes occurred and repeated following changes that were intended to improve access to on-site mental health care.

Results: In the first set of interviews, prior to expanding mental health services, primary care providers and support staff were generally dissatisfied with the availability and scheduling of on-site mental health care. Patients were often referred outside the primary care clinic for mental health treatment, to the detriment of communication and coordinated care. Follow-up interviews conducted after expansion of mental health services, scheduling refinements and other system changes revealed improved provider satisfaction in treatment access and coordination of care. Providers appreciated immediate and on-site social worker availability to triage mental health needs and help access care, and on-site treatment was viewed as important for remaining informed about patient care the primary care providers are not delivering directly.

Conclusions: Expanding integrated mental health services resulted in increased staff and provider satisfaction. Our evaluation identified key components of satisfaction, including on-site collaboration and assistance triaging patient needs. The sustainability of integrated models of care requires additional study.

Keywords: Anxiety disorders; Delivery of health care; Integrated; Mental health.

MeSH terms

  • Attitude of Health Personnel
  • Delivery of Health Care, Integrated / organization & administration*
  • Female
  • Health Services Accessibility / organization & administration*
  • Humans
  • Interviews as Topic
  • Male
  • Mental Health Services / organization & administration*
  • Physicians, Primary Care / psychology
  • Primary Health Care / organization & administration*
  • Referral and Consultation / organization & administration