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Integrated Primary Care and Mental Health Service Utilization: A Meta-Analysis.

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Area of Science:

  • Health Services Research
  • Mental Health Services
  • Primary Care Integration

Background:

  • Integrated primary care (IPC) models are theorized to enhance patient outcomes by improving access to mental health interventions.
  • The current study evaluates the impact of IPC on the utilization of mental health services.

Purpose of the Study:

  • To conduct a meta-analytic evaluation of the effect of integrated primary care models on mental health service utilization.
  • To compare mental health service use in IPC settings versus usual or enhanced usual primary care.

Main Methods:

  • A systematic literature search was performed across multiple databases (Medline, EMBASE, CENTRAL, PsycINFO, SCOPUS) for studies published between January 1, 1998, and December 15, 2024.
  • Twelve randomized and nonrandomized trials meeting inclusion criteria (≥10 participants per arm) were included in a multilevel meta-analysis.
  • Data extraction and screening were conducted by two independent reviewers to determine odds ratios (ORs) for receiving mental health treatment.

Main Results:

  • Integrated primary care significantly increased the odds of receiving any mental health intervention (OR, 12.23; 95% CI, 3.64-41.07).
  • IPC models also showed higher odds for receiving a minimum dose (OR, 10.92; 95% CI, 3.28-36.32) and a full course of intervention (OR, 19.17; 95% CI, 3.02-121.53).

Conclusions:

  • Integrated primary care models demonstrate a significant positive impact on the reach and utilization of mental health services.
  • Limitations include interstudy heterogeneity and a need for further research to identify specific IPC model components driving increased service access and use.