ArticleQuality & safety in health care2007
Outcomes of a quality improvement project integrating mental health into primary care.
Article in Quality & safety in health care, 2007. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
18 citing papers in PubMed, 4 syntheses or guidelines pooled it, 48 citations in OpenAlex.
- Adherence to evidence-based treatment guidelines for depression: a systematic review.BMC psychiatry · 2025Pooled it
- Interventions to improve veterans' access to care: a systematic review of the literature.Journal of general internal medicine · 2011Pooled it
- Integration of priority population, health and nutrition interventions into health systems: systematic review.BMC public health · 2011Pooled it
- The SQUIRE (Standards for QUality Improvement Reporting Excellence) guidelines for quality improvement reporting: explanation and elaboration.Quality & safety in health care · 2008Guideline
- Evaluating a complex model designed to increase access to high quality primary mental health care for under-served groups: a multi-method study.BMC health services research · 2016Trial
- Article
- A Unique Multi- and Interdisciplinary Cardiology-Renal-Endocrine Clinic: A Description and Assessment of Outcomes.Canadian journal of kidney health and disease · 2022Article
- Reducing the Impacts of Mental Health Stigma Through Integrated Primary Care: An Examination of the Evidence.Journal of clinical psychology in medical settings · 2021Review
- Typology of organizational innovation components: building blocks to improve access to primary healthcare for vulnerable populations.International journal for equity in health · 2020Review
- Impact of a mental health clinical pharmacist on a primary care mental health integration team.The mental health clinician · 2017Article
- Using implementation facilitation to foster clinical practice quality and adherence to evidence in challenged settings: a qualitative study.BMC health services research · 2017Article
- Mental Health Recovery in the Patient-Centered Medical Home.American journal of public health · 2015Article
- An Evidence Roadmap for Implementation of Integrated Behavioral Health under the Affordable Care Act.AIMS public health · 2015Review
- Predictors of primary care management of depression in the Veterans Affairs healthcare system.Journal of general internal medicine · 2014Article
- Article
- Determinants of readiness for primary care-mental health integration (PC-MHI) in the VA Health Care System.Journal of general internal medicine · 2013Article
- Clinical effectiveness of using an integrated model to treat depressive symptoms in veterans affairs primary care clinics and its impact on health care utilization.The primary care companion for CNS disorders · 2011Article
- The challenge of integrated care for mental health: leaving the 50 minute hour and other sacred things.Journal of clinical psychology in medical settings · 2009Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveDepression is commonly seen, but infrequently adequately treated, in primary care clinics. Improving access to depression care in primary care clinics has improved outcomes in clinical trials; however, these interventions are largely unstudied in clinical settings. This study examined the effectiveness of a quality improvement project improving access to mental healthcare in a large primary care clinic.
methodsA before-after study evaluating the efficacy of the integration of a primary mental healthcare (PMHC) clinic into a large primary care clinic at the White River Junction, Vermont Veterans Affairs Medical Center (VAMC). In the before period (2003), a traditional referral and schedule model was used to access mental healthcare services. Patients who had screened positive for depression using a depression screen for 6 months after entry into either model were retrospectively followed. VA clinics without a PMHC were used as a control. The proportion of patients who received any depression treatment and guideline-adhering depression treatment in each model was compared, as well as the volume of patients seen in mental health clinics and the wait time to be seen by mental health personnel.
results383 and 287 patients screened positive for depression at VAMC and the community-based outreach clinic, respectively. Demographics of the before and after cohorts did not differ. The PMHC model was associated with a greater proportion of patients who had screened positive for depression obtaining some depression treatment (52.3% vs 37.8%; p<0.001), an increase in guideline-adherent depression treatment for depression (11% vs 1%; p<0.001).
conclusionsImplementation of the PMHC model was associated with more rapid and improved treatment for depression in the population of patients who screened positive for depression. More widespread implementation of this model should be investigated.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.