Mental health services in army primary care: The need for a collaborative health care agenda

C. C. Engel, Kurt Kroenke, W. J. Katon

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Epidemiologic studies have shown that more than half of mentally ill patients in the United States receive their psychiatric care exclusively in primary care settings. This fraction may be even higher in the military due to concern over possible occupational repercussions resulting from use of specialty psychiatric care and specialist shortages. Collaboration between generalists and mental health care specialists could potentially improve mental health care delivery and reduce psychiatric disability for a large segment of the Army population who have a psychiatric disorder but may not seek specialty care. Collaborative efforts can reinforce military generalists' essential gate-keeping function, thereby decreasing unnecessary medical utilization and health care costs. The authors review the problems associated with mental health care delivery in primary care and provide examples of collaborative models previously studied or currently being explored. A four-part Army Primary Care-Mental Health Services Agenda is proposed, consisting of: (1) coordinated research including primary care- mental health services research and community-based epidemiologic studies; (2) formation of a primary care-mental health services advisory committee for aiding with policy and program development; (3) graduate and continuing medical education in primary care-mental health services emphasizing interdisciplinary collaborative skills; and (4) clinical implementation of feasible collaborative interdisciplinary mental health care models adapted to the range of unique Army primary care settings. The main goal of the Army Primary Care-Mental Health Services Agenda is to improve access to Army mental health care in the most efficacious and cost-effective way and to help minimize the organizational impact of disability related to psychosocial distress.

Original languageEnglish (US)
Pages (from-to)203-209
Number of pages7
JournalMilitary Medicine
Volume159
Issue number3
StatePublished - 1994
Externally publishedYes

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Mental Health Services
Primary Health Care
Delivery of Health Care
Mental Health
Psychiatry
Health Care Costs
Epidemiologic Studies
Graduate Medical Education
Continuing Medical Education
Program Development
Policy Making
Health Services Research
Mentally Ill Persons
Advisory Committees
Costs and Cost Analysis
Research
Population

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

Cite this

Mental health services in army primary care : The need for a collaborative health care agenda. / Engel, C. C.; Kroenke, Kurt; Katon, W. J.

In: Military Medicine, Vol. 159, No. 3, 1994, p. 203-209.

Research output: Contribution to journalArticle

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