ABSTRACT
OBJECTIVE: Despite the recognized importance of integrated behavioral health, particularly in safety net primary care, its effectiveness in real world settings has not been extensively evaluated. This article presents 2 successive studies examining the effectiveness of integrated behavioral care in a safety net setting. METHOD: Study 1 compared the depression and anxiety scores of predominately low-income and minority patients who underwent brief interventions (N = 147) to those of patients from a demographically similar comparison clinic without integrated psychological services, matched on baseline levels of anxiety and depression and length of time between assessments (N = 139). Study 2 did not include a control group but served as a long-term follow-up assessment of anxiety and depression for a subset of 47 patients who finished treatment and could be reached by telephone within 6-18 months of their last session. RESULTS: Study 1 found that patients from the clinic with integrated psychology services experienced greater decreases in depression and anxiety scores than patients in the control clinic. These effects did not differ as a function of age, gender, or race. Study 2 found that patients continued to decline in depression and anxiety over time, with lower scores at the last session and even lower scores after longer-term follow-up ranging from 6 to18 months. These improvements remained significant when controlling for other interim mental health treatments. CONCLUSION: These results support the short- and long-term treatment effects of brief primary care behavioral interventions, further strengthening the case for integrated behavioral healthcare in safety net settings.
Subject(s)
Anxiety Disorders/therapy , Depressive Disorder/therapy , Disease Progression , Mental Health Services , Outcome and Process Assessment, Health Care , Primary Health Care , Psychotherapy/methods , Safety-net Providers , Adult , Anxiety Disorders/physiopathology , Comorbidity , Depressive Disorder/physiopathology , Female , Follow-Up Studies , Humans , Male , Mental Health Services/organization & administration , Mental Health Services/standards , Middle Aged , Primary Health Care/organization & administration , Primary Health Care/standards , Safety-net Providers/organization & administration , Safety-net Providers/standardsABSTRACT
OBJECTIVES: To determine if family caregivers of hospitalized individuals with dementia exhibit greater depression severity than caregivers of outpatients. METHODS: Caregivers were recruited during care recipient treatment. Measures assessed depression, stress, burden, and grief. RESULTS: Forty-one caregivers of a hospitalized patient and 44 caregivers of an outpatient (total N = 85) were recruited. The groups did not differ except caregivers of hospitalized patients were younger and less likely to reside with the care recipient. Regarding depression, 63.4% of caregivers of a hospitalized patient and 43.2% of caregivers of an outpatient scored within the clinical depressive symptoms range. Independent sample t-tests showed that caregivers of a hospitalized patient had greater severity of depression, burden, and grief. Caregiving for a hospitalized person remained a significant predictor of greater depression severity in regression models. CONCLUSIONS: Family caregiving for a person hospitalized for psychiatric treatment of dementia is a risk factor for depression.
