OBJECTIVE: We assessed if an ongoing, multifaceted quality improvement program improved mental health care in a low-income, uninsured primary care clinic. METHODS: We reviewed the charts of 500 consecutive patients in 1999 and 500 consecutive patients in 2004 to compare the number of mental health visits; the percentage of patients with more than three follow-up visits; the percentage with > or = 1 visit with a prescribing provider and the percentage with a psychiatric medication prescribed. We also assessed whether patients with more than one charted mental illness received more care than patients with one mental illness. RESULTS: Compared to 1999, patients in 2004 had significantly more visits in the first 120 days (acute phase) of treatment (3.16 vs. 4.81, P<.001) and more visits in up to 9 months post acute phase (3.76 vs. 4.88, P>.012). A higher percentage of patients in the acute phase (28.9% vs. 49.5%, P<.001) had three follow-up visits, saw a medical provider and received a prescription. Patients with multiple charted mental illnesses had more visits than patients with one mental illness in 2004 but not in 1999 (P<.001). CONCLUSIONS: An ongoing, multifaceted intervention improved the quality of mental health care in a primary care population with a high prevalence of mental illness.
OBJECTIVE: We assessed if an ongoing, multifaceted quality improvement program improved mental health care in a low-income, uninsured primary care clinic. METHODS: We reviewed the charts of 500 consecutive patients in 1999 and 500 consecutive patients in 2004 to compare the number of mental health visits; the percentage of patients with more than three follow-up visits; the percentage with > or = 1 visit with a prescribing provider and the percentage with a psychiatric medication prescribed. We also assessed whether patients with more than one charted mental illness received more care than patients with one mental illness. RESULTS: Compared to 1999, patients in 2004 had significantly more visits in the first 120 days (acute phase) of treatment (3.16 vs. 4.81, P<.001) and more visits in up to 9 months post acute phase (3.76 vs. 4.88, P>.012). A higher percentage of patients in the acute phase (28.9% vs. 49.5%, P<.001) had three follow-up visits, saw a medical provider and received a prescription. Patients with multiple charted mental illnesses had more visits than patients with one mental illness in 2004 but not in 1999 (P<.001). CONCLUSIONS: An ongoing, multifaceted intervention improved the quality of mental health care in a primary care population with a high prevalence of mental illness.