Telephone Outreach Aids Depression Screening: Intervention Encourages Medically Ill Patients to Use Mental Health Services in Primary Care Practices

Article excerpt

CHICAGO -- Telephone-based outreach is an effective screening tool for identifying comorbid depression in medically ill patients, said Michael Ong, M.D., of Stanford (Calif.) University.

Such an intervention can be incorporated into primary care as a way to connect at-risk patients with mental health care services.

As part of an ongoing study of mental health care utilization and the cost effectiveness of outreach services, he and his colleagues identified a cohort of medically ill individuals using administrative health care utilization data from a large national employer. Prior studies have shown that medically ill patients often have comorbid mental illness, particularly depression, but are less likely than other patients to use mental health services. It is believed that early detection and treatment of depression could minimize the health and economic costs of the disease.

Of the primary care patients in the study, 104 were assigned using a nonrandomized method to an intervention group and 158 to a control group matched by demographics, medical diagnosis, and prior year medical costs, Dr. Ong said at the annual meeting of the Society of General Internal Medicine.

Patients in the intervention arm were contacted via telephone by outreach counselors who performed behavioral health screening and offered referrals to mental health clinicians, support groups, support services, financial counseling, and legal aid. Preliminary data show that 70% of the patients in the intervention group accepted a referral from the outreach service, and 95% were satisfied with their interaction with that service, he reported.

Specialty mental health utilization increased in the intervention group, rising from no utilization in the year prior to the intervention to 27 users in the year after the intervention. Of the specialty mental health claims, 43% were for depression and 20% were for adjustment disorder. …