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Improving Access to Collaborative Behavioral Health Care for Rural-Dwelling Older Adults
Lauren B Gerlach1, Shahrzad Mavandadi1, Donovan T Maust1
1Dr. Gerlach and Dr. Maust are with the Department of Psychiatry, University of Michigan, Ann Arbor. Dr. Maust is also with the Department of Psychiatry, Department of Veterans Affairs (VA) Ann Arbor Healthcare System. Dr. Mavandadi, Dr. Streim, and Dr. Oslin are with the Department of Psychiatry, Corporal Michael J. Crescenz VA Medical Center, and the Department of Psychiatry, University of Pennsylvania, Philadelphia.
Objective:
This study examined whether a telephone-delivered collaborative care intervention (SUpporting Seniors Receiving Treatment And INtervention [SUSTAIN]) improved access to mental health services similarly among older adults in rural areas and those in urban-suburban areas.
Methods:
This cohort study of 8,621 older adults participating in the SUSTAIN program, a clinical service provided to older adults in Pennsylvania newly prescribed a psychotropic medication by a primary care or non-mental health provider, examined rural versus urban-suburban differences in rates of initial clinical interview completion, patient clinical characteristics, and program penetration.
Results:
Participants in rural counties were more likely than those in urban-suburban counties to complete the initial clinical interview (27.0% versus 24.0%, p=.001). Program penetration was significantly higher in rural than in urban-suburban counties (p=.02).
Conclusions:
Telephone-based care management programs such as SUSTAIN may be an effective strategy to facilitate access to collaborative mental health care regardless of patients' geographic location.
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