Expanding Mental Health Services to Older High-Utilizing HMO Patients: A Pilot Study |
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Authors: | Leonard J Haas David C Spendlove Michael P Silver |
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Institution: | (1) Department of Family and Preventive Medicine, University of Utah Health Sciences Center, Salt Lake City, Utah;(2) St Mark's Family Medicine Residency, Salt Lake City, Utah;(3) Health Insights, Inc., Salt Lake City, Utah |
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Abstract: | Background: Expanded mental health benefits were offered to older HMO patients who were high medical utilizers. Outcomes of interest were use of services, subjective well-being, and psychopathology. Methods: Sixty-nine (25 male, 44 female) patients age 55 or above seeking frequent outpatient medical care completed the SF-36 health survey and the revised Symptom Check List (SCL-90-R). Patients were assigned to usual care, health education, or expanded mental health benefit conditions. Results: Patients showed high initial levels of psychopathology and distress. Over the 6 months of the study, patients in the expanded benefits group made a mean of 11.5 visits to mental health professionals versus a mean of 3.4 visits by usual care patients. Patients in the expanded benefits group showed significant improvement in SF-36 General Health and Mental Health well-being scores. Patients in the health education group showed no improvement. Patients in the usual care group showed improvements in Vitality scores. Psychopathology summary scores showed improvement for both usual care and enhanced benefit groups. Conclusions: Mental health treatment may improve well-being and reduce psychopathology in older high-utilizing patients. Creativity will be needed in expanding access to mental health services for this population. |
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Keywords: | mental health services access and barriers managed care distressed high utilizers |
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