Jennifer Moye1, Grant Harris2, Erin Kube3, Bret Hicken4, Omonyêlé Adjognon5, Kenneth Shay6, Jennifer L Sullivan7. 1. VA New England Geriatric Research Education and Clinical Center (JM), VA Boston Healthcare System, Jamaica Plain, MA; Department of Psychiatry (JM), Harvard Medical School, Boston, MA. Electronic address: jennifer.moye@va.gov. 2. Geriatric Primary Care Clinic (GH), St. Louis VA Healthcare System, St. Louis, MO. 3. Iora Primary Care (EK), Glendale, AZ; School of Social and Behavioral Sciences (EK), Arizona State University, Tempe, AZ. 4. Veterans Rural Health Resource Center (BH), Salt Lake City, UT; George E. Wahlen Veterans Affairs Medical Center (BH), Salt Lake City, UT; Department of Counseling Psychology (BH), University of Utah, Salt Lake City, UT. 5. Center for Healthcare Organization and Implementation Research (OA, JLS), VA Boston Healthcare System, Boston, MA. 6. Office of Geriatrics and Extended Care Services (KS), U.S. Department of Veterans Affairs, Ann Arbor, MI. 7. Center for Healthcare Organization and Implementation Research (OA, JLS), VA Boston Healthcare System, Boston, MA; Boston University School of Public Health (JLS), Boston, MA.
Abstract
OBJECTIVES: To inform geriatric mental health policy by describing the role of behavioral healthcare providers within a geriatric patient-aligned care team (GeriPACT), a patient-centered medical home model of care within the Veterans Health Administration (VHA), serving older veterans with chronic disease, functional dependency, cognitive decline, and psychosocial challenges, and/or those who have elder abuse, risk of long-term care placement, or impending disability. METHODS: The authors used mixed methods, consisting of a national survey and site visits between July 2016 and February 2017, at VHA outpatient clinics. The participants, 101 GeriPACTs at 44 sites, completed surveys, and 24 medical providers were interviewed. A standardized survey and semi-structured interview guide were developed based on the program handbook, with input from experts in the VHA Office of Geriatrics and Extended Care Services, guided by the Consolidated Framework for Implementation Science Research. RESULTS: Of surveyed GeriPACTs, 42.6% had a mental health provider on the team-a psychiatrist (28.7%) and/or psychologist (23.8%). Of these, the mean was 0.27 full-time equivalent psychiatrists and 0.44 full-time equivalent psychologists per team (suggested panel = 800 patients). In surveys, teams with behavioral health providers were more likely to manage psychosocial χ2 = 8.87, cognitive χ2 = 8.68, and depressive χ2 = 11.85 conditions in their panel than those without behavioral health providers. CONCLUSION: GeriPACT mental health integration is less than 50%. Population differences between general primary care and geriatric primary care may require different care approaches and provider competencies and need further study. Published by Elsevier Inc.
OBJECTIVES: To inform geriatric mental health policy by describing the role of behavioral healthcare providers within a geriatric patient-aligned care team (GeriPACT), a patient-centered medical home model of care within the Veterans Health Administration (VHA), serving older veterans with chronic disease, functional dependency, cognitive decline, and psychosocial challenges, and/or those who have elder abuse, risk of long-term care placement, or impending disability. METHODS: The authors used mixed methods, consisting of a national survey and site visits between July 2016 and February 2017, at VHA outpatient clinics. The participants, 101 GeriPACTs at 44 sites, completed surveys, and 24 medical providers were interviewed. A standardized survey and semi-structured interview guide were developed based on the program handbook, with input from experts in the VHA Office of Geriatrics and Extended Care Services, guided by the Consolidated Framework for Implementation Science Research. RESULTS: Of surveyed GeriPACTs, 42.6% had a mental health provider on the team-a psychiatrist (28.7%) and/or psychologist (23.8%). Of these, the mean was 0.27 full-time equivalent psychiatrists and 0.44 full-time equivalent psychologists per team (suggested panel = 800 patients). In surveys, teams with behavioral health providers were more likely to manage psychosocial χ2 = 8.87, cognitive χ2 = 8.68, and depressive χ2 = 11.85 conditions in their panel than those without behavioral health providers. CONCLUSION: GeriPACT mental health integration is less than 50%. Population differences between general primary care and geriatric primary care may require different care approaches and provider competencies and need further study. Published by Elsevier Inc.
Entities:
Keywords:
Mental health; integrated delivery of care; policy; primary healthcare
Authors: Joseph J Gallo; Cynthia Zubritsky; James Maxwell; Michael Nazar; Hillary R Bogner; Louise M Quijano; Heidi J Syropoulos; Karen L Cheal; Hongtu Chen; Herman Sanchez; John Dodson; Sue E Levkoff Journal: Ann Fam Med Date: 2004 Jul-Aug Impact factor: 5.166
Authors: Wayne J Katon; Elizabeth H B Lin; Michael Von Korff; Paul Ciechanowski; Evette J Ludman; Bessie Young; Do Peterson; Carolyn M Rutter; Mary McGregor; David McCulloch Journal: N Engl J Med Date: 2010-12-30 Impact factor: 91.245
Authors: Steven K Dobscha; Kathryn Corson; Nancy A Perrin; Ginger C Hanson; Ruth Q Leibowitz; Melanie N Doak; Kathryn C Dickinson; Mark D Sullivan; Martha S Gerrity Journal: JAMA Date: 2009-03-25 Impact factor: 56.272
Authors: Jennifer L Sullivan; Rina Eisenstein; Thomas Price; Samantha Solimeo; Kenneth Shay Journal: J Am Board Fam Med Date: 2018 May-Jun Impact factor: 2.657
Authors: Melissa M Thomas; Ilan Harpaz-Rotem; Jack Tsai; Steven M Southwick; Robert H Pietrzak Journal: Prim Care Companion CNS Disord Date: 2017-06-22
Authors: Chelsea E Hawley; Nicole Genovese; Montgomery T Owsiany; Laura K Triantafylidis; Lauren R Moo; Amy M Linsky; Jennifer L Sullivan; Julie M Paik Journal: J Am Geriatr Soc Date: 2020-10-04 Impact factor: 7.538