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Research ArticleOriginal Research

Changing Patterns of Mental Health Care Use: The Role of Integrated Mental Health Services in Veteran Affairs Primary Care

Lucinda B. Leung, Jean Yoon, Lisa V. Rubenstein, Edward P. Post, Maureen E. Metzger, Kenneth B. Wells, Catherine A. Sugar and José J. Escarce
The Journal of the American Board of Family Medicine January 2018, 31 (1) 38-48; DOI: https://doi.org/10.3122/jabfm.2018.01.170157
Lucinda B. Leung
From the VA Health Services Research and Development (HSR&D) Center for the Study of Healthcare Innovation, Implementation, & Policy, Greater Los Angeles VA Healthcare System, Los Angeles, CA (LBL, LVR, KBW); Division of General Internal Medicine and Health Services Research, University of California–Los Angeles (UCLA) David Geffen School of Medicine, Los Angeles (LBL, LVR, JJE); VA Health Economics Resource Center, VA Palo Alto Healthcare System, Menlo Park, CA (JY); Department of General Internal Medicine, University of California–San Francisco School of Medicine, San Francisco, CA (JY); RAND Corporation, Santa Monica, CA (LVR, KBW); UCLA School of Public Health, Los Angeles (LVR, KBW, CAS, JJE); VA Center for Clinical Management Research, Ann Arbor, MI (EPP, MEM); University of Michigan Medical School, Ann Arbor (EPP); UCLA Center for Health Services and Society, Los Angeles (KBW); 10UCLA Semel Institute for Neuroscience and Human Behavior, Los Angeles (KBW, CAS).
MD, PhD, MPH
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Jean Yoon
From the VA Health Services Research and Development (HSR&D) Center for the Study of Healthcare Innovation, Implementation, & Policy, Greater Los Angeles VA Healthcare System, Los Angeles, CA (LBL, LVR, KBW); Division of General Internal Medicine and Health Services Research, University of California–Los Angeles (UCLA) David Geffen School of Medicine, Los Angeles (LBL, LVR, JJE); VA Health Economics Resource Center, VA Palo Alto Healthcare System, Menlo Park, CA (JY); Department of General Internal Medicine, University of California–San Francisco School of Medicine, San Francisco, CA (JY); RAND Corporation, Santa Monica, CA (LVR, KBW); UCLA School of Public Health, Los Angeles (LVR, KBW, CAS, JJE); VA Center for Clinical Management Research, Ann Arbor, MI (EPP, MEM); University of Michigan Medical School, Ann Arbor (EPP); UCLA Center for Health Services and Society, Los Angeles (KBW); 10UCLA Semel Institute for Neuroscience and Human Behavior, Los Angeles (KBW, CAS).
PhD
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Lisa V. Rubenstein
From the VA Health Services Research and Development (HSR&D) Center for the Study of Healthcare Innovation, Implementation, & Policy, Greater Los Angeles VA Healthcare System, Los Angeles, CA (LBL, LVR, KBW); Division of General Internal Medicine and Health Services Research, University of California–Los Angeles (UCLA) David Geffen School of Medicine, Los Angeles (LBL, LVR, JJE); VA Health Economics Resource Center, VA Palo Alto Healthcare System, Menlo Park, CA (JY); Department of General Internal Medicine, University of California–San Francisco School of Medicine, San Francisco, CA (JY); RAND Corporation, Santa Monica, CA (LVR, KBW); UCLA School of Public Health, Los Angeles (LVR, KBW, CAS, JJE); VA Center for Clinical Management Research, Ann Arbor, MI (EPP, MEM); University of Michigan Medical School, Ann Arbor (EPP); UCLA Center for Health Services and Society, Los Angeles (KBW); 10UCLA Semel Institute for Neuroscience and Human Behavior, Los Angeles (KBW, CAS).
MD, MSPH
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Edward P. Post
From the VA Health Services Research and Development (HSR&D) Center for the Study of Healthcare Innovation, Implementation, & Policy, Greater Los Angeles VA Healthcare System, Los Angeles, CA (LBL, LVR, KBW); Division of General Internal Medicine and Health Services Research, University of California–Los Angeles (UCLA) David Geffen School of Medicine, Los Angeles (LBL, LVR, JJE); VA Health Economics Resource Center, VA Palo Alto Healthcare System, Menlo Park, CA (JY); Department of General Internal Medicine, University of California–San Francisco School of Medicine, San Francisco, CA (JY); RAND Corporation, Santa Monica, CA (LVR, KBW); UCLA School of Public Health, Los Angeles (LVR, KBW, CAS, JJE); VA Center for Clinical Management Research, Ann Arbor, MI (EPP, MEM); University of Michigan Medical School, Ann Arbor (EPP); UCLA Center for Health Services and Society, Los Angeles (KBW); 10UCLA Semel Institute for Neuroscience and Human Behavior, Los Angeles (KBW, CAS).
MD, PhD
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Maureen E. Metzger
From the VA Health Services Research and Development (HSR&D) Center for the Study of Healthcare Innovation, Implementation, & Policy, Greater Los Angeles VA Healthcare System, Los Angeles, CA (LBL, LVR, KBW); Division of General Internal Medicine and Health Services Research, University of California–Los Angeles (UCLA) David Geffen School of Medicine, Los Angeles (LBL, LVR, JJE); VA Health Economics Resource Center, VA Palo Alto Healthcare System, Menlo Park, CA (JY); Department of General Internal Medicine, University of California–San Francisco School of Medicine, San Francisco, CA (JY); RAND Corporation, Santa Monica, CA (LVR, KBW); UCLA School of Public Health, Los Angeles (LVR, KBW, CAS, JJE); VA Center for Clinical Management Research, Ann Arbor, MI (EPP, MEM); University of Michigan Medical School, Ann Arbor (EPP); UCLA Center for Health Services and Society, Los Angeles (KBW); 10UCLA Semel Institute for Neuroscience and Human Behavior, Los Angeles (KBW, CAS).
PhD, MPH
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Kenneth B. Wells
From the VA Health Services Research and Development (HSR&D) Center for the Study of Healthcare Innovation, Implementation, & Policy, Greater Los Angeles VA Healthcare System, Los Angeles, CA (LBL, LVR, KBW); Division of General Internal Medicine and Health Services Research, University of California–Los Angeles (UCLA) David Geffen School of Medicine, Los Angeles (LBL, LVR, JJE); VA Health Economics Resource Center, VA Palo Alto Healthcare System, Menlo Park, CA (JY); Department of General Internal Medicine, University of California–San Francisco School of Medicine, San Francisco, CA (JY); RAND Corporation, Santa Monica, CA (LVR, KBW); UCLA School of Public Health, Los Angeles (LVR, KBW, CAS, JJE); VA Center for Clinical Management Research, Ann Arbor, MI (EPP, MEM); University of Michigan Medical School, Ann Arbor (EPP); UCLA Center for Health Services and Society, Los Angeles (KBW); 10UCLA Semel Institute for Neuroscience and Human Behavior, Los Angeles (KBW, CAS).
MD, MPH
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Catherine A. Sugar
From the VA Health Services Research and Development (HSR&D) Center for the Study of Healthcare Innovation, Implementation, & Policy, Greater Los Angeles VA Healthcare System, Los Angeles, CA (LBL, LVR, KBW); Division of General Internal Medicine and Health Services Research, University of California–Los Angeles (UCLA) David Geffen School of Medicine, Los Angeles (LBL, LVR, JJE); VA Health Economics Resource Center, VA Palo Alto Healthcare System, Menlo Park, CA (JY); Department of General Internal Medicine, University of California–San Francisco School of Medicine, San Francisco, CA (JY); RAND Corporation, Santa Monica, CA (LVR, KBW); UCLA School of Public Health, Los Angeles (LVR, KBW, CAS, JJE); VA Center for Clinical Management Research, Ann Arbor, MI (EPP, MEM); University of Michigan Medical School, Ann Arbor (EPP); UCLA Center for Health Services and Society, Los Angeles (KBW); 10UCLA Semel Institute for Neuroscience and Human Behavior, Los Angeles (KBW, CAS).
PhD
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José J. Escarce
From the VA Health Services Research and Development (HSR&D) Center for the Study of Healthcare Innovation, Implementation, & Policy, Greater Los Angeles VA Healthcare System, Los Angeles, CA (LBL, LVR, KBW); Division of General Internal Medicine and Health Services Research, University of California–Los Angeles (UCLA) David Geffen School of Medicine, Los Angeles (LBL, LVR, JJE); VA Health Economics Resource Center, VA Palo Alto Healthcare System, Menlo Park, CA (JY); Department of General Internal Medicine, University of California–San Francisco School of Medicine, San Francisco, CA (JY); RAND Corporation, Santa Monica, CA (LVR, KBW); UCLA School of Public Health, Los Angeles (LVR, KBW, CAS, JJE); VA Center for Clinical Management Research, Ann Arbor, MI (EPP, MEM); University of Michigan Medical School, Ann Arbor (EPP); UCLA Center for Health Services and Society, Los Angeles (KBW); 10UCLA Semel Institute for Neuroscience and Human Behavior, Los Angeles (KBW, CAS).
MD, PhD
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Article Information

vol. 31 no. 1 38-48
DOI 
https://doi.org/10.3122/jabfm.2018.01.170157
PubMed 
29330238

Published By 
The Journal of the American Board of Family Medicine
Print ISSN 
1557-2625
Online ISSN 
1558-7118
History 
  • Received for publication April 11, 2017
  • Revision received August 10, 2017
  • Accepted for publication August 14, 2017
  • Published online January 12, 2018.

Copyright & Usage 
© Copyright 2018 by the American Board of Family Medicine.

Author Information

  1. Lucinda B. Leung, MD, PhD, MPH,
  2. Jean Yoon, PhD,
  3. Lisa V. Rubenstein, MD, MSPH,
  4. Edward P. Post, MD, PhD,
  5. Maureen E. Metzger, PhD, MPH,
  6. Kenneth B. Wells, MD, MPH,
  7. Catherine A. Sugar, PhD and
  8. José J. Escarce, MD, PhD
  1. From the VA Health Services Research and Development (HSR&D) Center for the Study of Healthcare Innovation, Implementation, & Policy, Greater Los Angeles VA Healthcare System, Los Angeles, CA (LBL, LVR, KBW); Division of General Internal Medicine and Health Services Research, University of California–Los Angeles (UCLA) David Geffen School of Medicine, Los Angeles (LBL, LVR, JJE); VA Health Economics Resource Center, VA Palo Alto Healthcare System, Menlo Park, CA (JY); Department of General Internal Medicine, University of California–San Francisco School of Medicine, San Francisco, CA (JY); RAND Corporation, Santa Monica, CA (LVR, KBW); UCLA School of Public Health, Los Angeles (LVR, KBW, CAS, JJE); VA Center for Clinical Management Research, Ann Arbor, MI (EPP, MEM); University of Michigan Medical School, Ann Arbor (EPP); UCLA Center for Health Services and Society, Los Angeles (KBW); 10UCLA Semel Institute for Neuroscience and Human Behavior, Los Angeles (KBW, CAS).
  1. Corresponding author: Lucinda B. Leung, MD, PhD, MPH, 11301 Wilshire Blvd (111G), Building 500, Room 3244, Los Angeles, CA 90073 (E-mail: lleung{at}mednet.ucla.edu).
  1. Prior presentations: We presented earlier versions of the manuscript at the 2016 Society of General Internal Medicine National Meeting in Hollywood, FL; 2016 AcademyHealth Annual Research Meeting in Boston, MA; and 2017 VA HSR&D/QUERI National Conference in Arlington, VA.

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The Journal of the American Board of Family     Medicine: 31 (1)
The Journal of the American Board of Family Medicine
Vol. 31, Issue 1
January-February 2018
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Changing Patterns of Mental Health Care Use: The Role of Integrated Mental Health Services in Veteran Affairs Primary Care
Lucinda B. Leung, Jean Yoon, Lisa V. Rubenstein, Edward P. Post, Maureen E. Metzger, Kenneth B. Wells, Catherine A. Sugar, José J. Escarce
The Journal of the American Board of Family Medicine Jan 2018, 31 (1) 38-48; DOI: 10.3122/jabfm.2018.01.170157

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Changing Patterns of Mental Health Care Use: The Role of Integrated Mental Health Services in Veteran Affairs Primary Care
Lucinda B. Leung, Jean Yoon, Lisa V. Rubenstein, Edward P. Post, Maureen E. Metzger, Kenneth B. Wells, Catherine A. Sugar, José J. Escarce
The Journal of the American Board of Family Medicine Jan 2018, 31 (1) 38-48; DOI: 10.3122/jabfm.2018.01.170157
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Keywords

  • Health Care Costs
  • Depressive Disorder
  • Mental Health
  • Patient-Centered Care
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