Evaluation of a collaborative mental health program in primary care: effects on patient distress and health care utilization

Background: The effectiveness of a collaborative model of mental health treatment under conditions of routine care in a primary care setting has received limited evaluation. Potential effects include reduced symptoms and decreased healthcare utilization. Methods: The present study describes treatment outcome for 234 patients seen by a mental health professional in a primary care clinic using a collaborative model of care. Patients were seen for one session (n = 120), two sessions (n = 59), three sessions (n = 29), or four or more sessions (n = 26). Patients completed the Outcome Questionnaire-45 (OQ45) at every session. Results: OQ-45 total scores for patients seen for more than one appointment showed statistically significant reductions in psychological distress from first to last session for all groups. Pre-treatment health care utilization was unrelated to level of psychological distress at the first session. A comparison of health care utilization for the six month period before and after the first session showed a small but statistically significant increase in total number of medical visits. Conclusions: The results support the effectiveness of a collaborative model of mental health care for reducing symptoms in patients seen in a primary care setting. Patient’s overall healthcare utilization in the short term was largely unaffected.