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Mental Health Recovery in the Patient-Centered Medical Home
Marisa Sklar1, Gregory A Aarons1, Maria O'Connell1
1Marisa Sklar is with San Diego State University-University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego. Gregory A. Aarons is with Department of Psychiatry, University of California San Diego, La Jolla. Maria O'Connell and Larry Davidson are with Department of Psychiatry, Yale School of Medicine, New Haven, CT. Erik J. Groessl is with Department of Family and Preventive Medicine, University of California San Diego.
Objectives:
We examined the impact of transitioning clients from a mental health clinic to a patient-centered medical home (PCMH) on mental health recovery.
Methods:
We drew data from a large US County Behavioral Health Services administrative data set. We used propensity score analysis and multilevel modeling to assess the impact of the PCMH on mental health recovery by comparing PCMH participants (n = 215) to clients receiving service as usual (SAU; n = 22,394) from 2011 to 2013 in San Diego County, California. We repeatedly assessed mental health recovery over time (days since baseline assessment range = 0-1639; mean = 186) with the Illness Management and Recovery (IMR) scale and Recovery Markers Questionnaire.
Results:
For total IMR (log-likelihood ratio χ(2)[1] = 4696.97; P < .001) and IMR Factor 2 Management scores (log-likelihood ratio χ(2)[1] = 7.9; P = .005), increases in mental health recovery over time were greater for PCMH than SAU participants. Increases on all other measures over time were similar for PCMH and SAU participants.
Conclusions:
Greater increases in mental health recovery over time can be expected when patients with severe mental illness are provided treatment through the PCMH. Evaluative efforts should be taken to inform more widespread adoption of the PCMH.
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