Author Interviews, JAMA, Mental Health Research, Primary Care / 13.11.2015
Telephone-Base Monitoring Plus Care Management Improved Mental Health Functioning
MedicalResearch.com Interview with:
Shahrzad Mavandadi, PhD
Research Health Science Specialist and Investigator
Veterans Integrated Services Network 4 Mental Illness Research,
Education, and Clinical Center
Corporal Michael J. Crescenz Veterans Affairs Medical Center
Philadelphia, Pennsylvania
Medical Research: What is the background for this study?
Dr. Mavandadi: Mental health (MH) conditions are underidentified and undertreated in later life. This is particularly true among subgroups of older adults who are more vulnerable to developing mental health issues, have poor access to specialty care, and are less responsive to treatment and therapy. Thus, we sought to evaluate longitudinal MH outcomes among low-income, community-dwelling older adults enrolled in an evidence-based, collaborative mental health care management service (i.e., the SUpporting Seniors Receiving Treatment And INtervention (SUSTAIN) program). The SUSTAIN program integrates mental health with primary care (which is where the majority of behavioral health conditions in later life are managed) and provides standardized, measurement-based, software-aided MH assessment and connection to community resources to older adults by telephone.
While there is a strong evidence base for the efficacy of collaborative care models for me conditions, little is known about the amount or level of patient and provider support that is needed to achieve optimal behavioral health outcomes. Thus, we specifically examined outcomes among older adults randomized to one of two program arms of varying intensity: MH symptom monitoring alone or mental health symptom monitoring plus MH care management. MH care management involved care managers who provided education, counseling, and decision support to patients and their primary care providers, a licensed mental health clinician who supervised the care managers, and the use of an algorithm to help guide pharmacological and non-pharmacological treatment plans. The sample consisted of 1018 older adults prescribed an antidepressant or anxiolytic by their non-behavioral health providers who presented with clinically significant symptoms at intake.
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