Associations of Administrative Variables with Setting and Type of Treatment (n = 2610)†
| Target | Primary Care | Specialty Mental Health | F5 | F1 | ||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Psychotherapy‡ (n = 290) | ADM (n = 439) | Combined (n = 219) | Total (n = 948) | Psychotherapy‡ (n = 697) | ADM (n = 373) | Combined (n = 592) | Total (n = 1662) | |||||||||||||
| Est | (S.E.) | Est | (S.E.) | Est | (S.E.) | Est | (S.E.) | Est | (S.E.) | Est | (S.E.) | Est | (S.E.) | Est | (S.E.) | Est | (S.E.) | |||
| Age | ||||||||||||||||||||
| 18 to 34 | 27.61 | (0.19) | −0.08 | (0.06) | −0.03 | (0.05) | 0.07 | (0.07) | −0.03 | (0.03) | −0.01 | (0.04) | 0.06 | (0.05) | 0.03 | (0.04) | 0.02 | (0.02) | 1.2 | 1.6 |
| 35 to 49 | 26.91 | (0.19) | −0.04 | (0.06) | −0.02 | (0.05) | −0.07 | (0.07) | −0.04 | (0.03) | −0.07 | (0.04) | 0.08 | (0.05) | 0.13 | (0.04) | 0.02 | (0.02) | 3.2 | 2.0 |
| 50 to 59 | 17.06 | (0.16) | −0.07 | (0.06) | −0.03 | (0.05) | 0.15 | (0.07) | −0.01 | (0.03) | 0.01 | (0.04) | −0.02 | (0.05) | 0.01 | (0.04) | 0.00 | (0.02) | 1.3 | 0.1 |
| 60+ | 28.42 | (0.19) | 0.18 | (0.06) | 0.08 | (0.05) | −0.13 | (0.06) | 0.08 | (0.03) | 0.07 | (0.04) | −0.12 | (0.05) | −0.18* | (0.04) | −0.04 | (0.02) | 8.6* | 8.7* |
| Sex | ||||||||||||||||||||
| Male | 82.67 | (0.16) | 0.09 | (0.06) | −0.09 | (0.05) | −0.03 | (0.07) | 0.01 | (0.03) | 0.06 | (0.04) | −0.05 | (0.05) | −0.09 | (0.04) | 0.00 | (0.02) | 2.9 | 0.1 |
| Race/ethnicity | ||||||||||||||||||||
| Non-Hispanic white | 60.84 | (0.21) | −0.08 | (0.06) | 0.03 | (0.05) | −0.10 | (0.07) | −0.05 | (0.03) | 0.05 | (0.04) | −0.02 | (0.05) | 0.01 | (0.04) | 0.03 | (0.02) | 1.6 | 3.3 |
| Non-Hispanic black | 25.12 | (0.18) | 0.12 | (0.06) | −0.05 | (0.05) | 0.07 | (0.07) | 0.05 | (0.03) | −0.04 | (0.04) | −0.01 | (0.05) | −0.02 | (0.04) | −0.03 | (0.02) | 1.8 | 3.9 |
| Hispanic | 10.30 | (0.13) | −0.05 | (0.05) | 0.01 | (0.05) | 0.07 | (0.07) | −0.01 | (0.03) | −0.02 | (0.04) | 0.06 | (0.06) | 0.01 | (0.04) | 0.00 | (0.02) | 0.8 | 0.1 |
| Other | 3.74 | (0.08) | 0.04 | (0.06) | 0.01 | (0.05) | 0.00 | (0.07) | 0.02 | (0.03) | −0.02 | (0.04) | −0.02 | (0.05) | 0.00 | (0.04) | −0.01 | (0.02) | 0.2 | 0.6 |
| Marital status | ||||||||||||||||||||
| Currently married | 48.60 | (0.21) | 0.04 | (0.06) | 0.05 | (0.05) | 0.00 | (0.07) | 0.04 | (0.03) | −0.03 | (0.04) | 0.07 | (0.05) | −0.06 | (0.04) | −0.02 | (0.02) | 1.1 | 1.7 |
| Divorced | 21.87 | (0.18) | −0.04 | (0.06) | −0.02 | (0.05) | 0.00 | (0.07) | −0.03 | (0.03) | 0.02 | (0.04) | −0.16* | (0.04) | 0.11 | (0.04) | 0.01 | (0.02) | 3.2 | 1.0 |
| Separated | 4.70 | (0.09) | −0.07 | (0.05) | −0.07 | (0.04) | −0.09 | (0.05) | −0.07 | (0.03) | 0.02 | (0.04) | 0.05 | (0.06) | 0.06 | (0.05) | 0.04 | (0.03) | 1.6 | 7.6 |
| Widowed | 2.14 | (0.06) | 0.05 | (0.07) | 0.06 | (0.06) | 0.02 | (0.07) | 0.05 | (0.04) | 0.00 | (0.04) | −0.03 | (0.05) | −0.06 | (0.03) | −0.02 | (0.02) | 0.8 | 2.8 |
| Never married | 22.69 | (0.18) | 0.01 | (0.06) | −0.01 | (0.05) | 0.04 | (0.07) | 0.01 | (0.03) | 0.00 | (0.04) | 0.05 | (0.05) | −0.05 | (0.04) | 0.00 | (0.02) | 0.5 | 0.1 |
| Census region | ||||||||||||||||||||
| Northeast | 10.77 | (0.13) | −0.09 | (0.05) | −0.15* | (0.04) | −0.20* | (0.04) | −0.13* | (0.03) | 0.11 | (0.04) | 0.01 | (0.05) | 0.02 | (0.04) | 0.07 | (0.03) | 5.9* | 23.3* |
| Midwest | 17.67 | (0.16) | −0.07 | (0.06) | −0.03 | (0.05) | 0.00 | (0.07) | −0.04 | (0.03) | 0.06 | (0.04) | −0.03 | (0.05) | 0.00 | (0.04) | 0.02 | (0.02) | 1.1 | 2.4 |
| South | 50.64 | (0.21) | 0.12 | (0.06) | 0.07 | (0.05) | 0.14 | (0.07) | 0.11* | (0.03) | −0.13* | (0.04) | 0.08 | (0.05) | −0.01 | (0.04) | −0.06 | (0.02) | 5.6* | 15.6* |
| West | 20.92 | (0.17) | −0.01 | (0.06) | 0.05 | (0.05) | −0.02 | (0.07) | 0.01 | (0.03) | 0.02 | (0.04) | −0.07 | (0.05) | 0.00 | (0.04) | 0.00 | (0.02) | 0.5 | 0.1 |
| Urbanicity | ||||||||||||||||||||
| Major metro | 85.87 | (0.15) | 0.13 | (0.05) | −0.04 | (0.05) | 0.18* | (0.05) | 0.09 | (0.03) | −0.15* | (0.04) | 0.01 | (0.05) | 0.10 | (0.04) | −0.04 | (0.03) | 7.7* | 10.0* |
| Urban | 12.73 | (0.14) | −0.14 | (0.05) | 0.06 | (0.05) | −0.18* | (0.05) | −0.08 | (0.03) | 0.15* | (0.04) | −0.01 | (0.05) | −0.10 | (0.04) | 0.04 | (0.03) | 8.0* | 9.8* |
| Rural | 1.40 | (0.05) | 0.01 | (0.06) | −0.05 | (0.04) | 0.00 | (0.07) | −0.01 | (0.03) | 0.02 | (0.04) | 0.01 | (0.05) | −0.01 | (0.04) | 0.01 | (0.03) | 0.2 | 0.3 |
| % of population below 1.5 of poverty line | ||||||||||||||||||||
| 1st quartile (low % with low income) | 25.00 | (0.18) | −0.08 | (0.06) | −0.06 | (0.05) | 0.13 | (0.07) | −0.03 | (0.03) | 0.04 | (0.04) | −0.06 | (0.05) | 0.02 | (0.04) | 0.02 | (0.02) | 2.0 | 1.3 |
| 2nd quartile | 25.00 | (0.18) | −0.01 | (0.06) | 0.07 | (0.05) | 0.03 | (0.07) | 0.02 | (0.03) | 0.00 | (0.04) | 0.00 | (0.05) | −0.05 | (0.04) | −0.01 | (0.02) | 0.5 | 0.7 |
| 3rd quartile | 25.00 | (0.18) | 0.00 | (0.06) | 0.04 | (0.05) | −0.10 | (0.06) | −0.01 | (0.03) | −0.01 | (0.04) | 0.06 | (0.05) | 0.00 | (0.04) | 0.00 | (0.02) | 0.7 | 0.1 |
| 4th quartile (high % with low income) | 25.00 | (0.18) | 0.09 | (0.06) | −0.05 | (0.05) | −0.06 | (0.07) | 0.01 | (0.03) | −0.03 | (0.04) | 0.00 | (0.05) | 0.03 | (0.04) | −0.01 | (0.02) | 1.2 | 0.2 |
| History of previously diagnosed mental disorders | ||||||||||||||||||||
| Depression | 47.99 | (0.21) | 0.00 | (0.06) | −0.09 | (0.05) | −0.09 | (0.07) | −0.05 | (0.03) | 0.02 | (0.04) | 0.03 | (0.05) | 0.03 | (0.04) | 0.03 | (0.02) | 1.0 | 3.3 |
| Anxiety | 28.27 | (0.19) | −0.04 | (0.06) | −0.19* | (0.04) | 0.00 | (0.07) | −0.08 | (0.03) | 0.01 | (0.04) | 0.10 | (0.05) | 0.06 | (0.04) | 0.04 | (0.03) | 3.2 | 8.8* |
| PTSD | 24.28 | (0.18) | −0.12 | (0.05) | −0.24* | (0.04) | −0.20* | (0.06) | −0.18* | (0.03) | 0.07 | (0.04) | 0.09 | (0.05) | 0.13 | (0.04) | 0.09* | (0.03) | 9.3* | 43.0* |
| Adjustment disorder | 16.10 | (0.16) | −0.05 | (0.06) | −0.20* | (0.04) | 0.00 | (0.07) | −0.09 | (0.03) | 0.05 | (0.04) | 0.03 | (0.05) | 0.06 | (0.04) | 0.05 | (0.03) | 3.4* | 11.0* |
| Other reactions to stress | 6.40 | (0.10) | −0.04 | (0.05) | −0.12 | (0.04) | −0.05 | (0.06) | −0.07 | (0.03) | −0.01 | (0.04) | 0.09 | (0.06) | 0.08 | (0.05) | 0.04 | (0.03) | 2.2 | 6.3 |
| Substance | 17.62 | (0.16) | −0.12 | (0.05) | −0.17* | (0.04) | −0.13 | (0.06) | −0.14* | (0.03) | 0.03 | (0.04) | 0.00 | (0.05) | 0.18* | (0.05) | 0.07 | (0.03) | 7.0* | 25.8* |
| Other disorders | 18.84 | (0.17) | −0.12 | (0.05) | −0.21* | (0.04) | −0.01 | (0.07) | −0.13* | (0.03) | 0.04 | (0.04) | 0.07 | (0.05) | 0.11 | (0.04) | 0.07 | (0.03) | 5.8* | 22.6* |
| Number of previously diagnosed mental disorders | ||||||||||||||||||||
| 0 | 30.29 | (0.20) | 0.07 | (0.06) | 0.28* | (0.05) | 0.11 | (0.07) | 0.15* | (0.03) | −0.07 | (0.04) | −0.09 | (0.05) | −0.08 | (0.04) | −0.08* | (0.02) | 7.6* | 29.9* |
| 1 | 22.00 | (0.18) | 0.09 | (0.06) | 0.03 | (0.05) | −0.04 | (0.07) | 0.04 | (0.03) | 0.00 | (0.04) | 0.01 | (0.05) | −0.09 | (0.04) | −0.02 | (0.02) | 1.7 | 2.6 |
| 2 | 21.34 | (0.17) | −0.06 | (0.06) | −0.09 | (0.04) | 0.10 | (0.07) | −0.04 | (0.03) | 0.02 | (0.04) | 0.02 | (0.05) | 0.02 | (0.04) | 0.02 | (0.02) | 1.3 | 1.8 |
| 3+ | 26.38 | (0.19) | −0.12 | (0.05) | −0.26* | (0.04) | −0.17 | (0.06) | −0.17* | (0.03) | 0.05 | (0.04) | 0.07 | (0.05) | 0.16* | (0.04) | 0.09* | (0.03) | 9.9* | 41.7* |
| Current depression treatment | ||||||||||||||||||||
| Primary | 58.16 | (0.21) | 0.27* | (0.05) | −0.38* | (0.05) | 0.07 | (0.07) | 0.02 | (0.03) | −0.04 | (0.04) | 0.04 | (0.05) | 0.02 | (0.04) | −0.01 | (0.02) | 15.6* | 0.3 |
| Secondary with primary physical | 16.96 | (0.16) | −0.24* | (0.04) | 0.78* | (0.06) | 0.02 | (0.07) | 0.14* | (0.04) | 0.06 | (0.04) | −0.22* | (0.04) | −0.22* | (0.03) | −0.07* | (0.02) | 53.9* | 28.1* |
| Secondary with primary other mental | 24.88 | (0.18) | −0.09 | (0.05) | −0.27* | (0.04) | −0.11 | (0.06) | −0.15* | (0.03) | −0.01 | (0.04) | 0.16 | (0.06) | 0.18* | (0.05) | 0.08 | (0.03) | 10.3* | 31.8* |
| Treatment location, setting, and type | ||||||||||||||||||||
| Seen in community-based clinic | 57.15 | (0.21) | 0.01 | (0.06) | −0.02 | (0.05) | −0.04 | (0.07) | −0.01 | (0.03) | 0.13* | (0.04) | −0.11 | (0.05) | −0.14* | (0.04) | 0.00 | (0.02) | 5.7* | 0.1 |
| Seen by primary care clinician | 39.64 | (0.21) | −0.35* | (0.05) | 0.78* | (0.03) | 0.35* | (0.07) | 0.16* | (0.03) | −0.16* | (0.04) | −0.05 | (0.05) | 0.03 | (0.04) | −0.08* | (0.02) | 60.5* | 34.9* |
| Received psychotherapy‡ | 89.29 | (0.20) | 0.34* | (0.01) | −1.44* | (0.08) | −0.21 | (0.08) | −0.35* | (0.04) | 0.35* | (0.00) | −0.03 | (0.05) | 0.02 | (0.04) | 0.18* | (0.02) | 217.4* | 179.1* |
| Received medication | 31.81 | (0.13) | −0.72* | (0.02) | 1.03* | (0.03) | 0.74* | (0.06) | 0.15* | (0.03) | −0.74* | (0.01) | 0.79* | (0.05) | 0.53* | (0.04) | −0.08* | (0.02) | 656.1* | 31.8* |
| Received PC-MHI treatment | 35.95 | (0.20) | 1.25* | (0.03) | −0.23* | (0.04) | 0.87* | (0.06) | 0.70* | (0.03) | −0.36* | (0.03) | −0.65* | (0.02) | −0.19* | (0.04) | −0.36* | (0.02) | 367.4* | 878.2* |
ADM, antidepressant medication; Est, standardized mean estimates; PC-MHI, primary care–mental health integration; PTSD, post-traumatic stress disorder; S.E., standard error.
↵* Significant at the 0.05 level, 2-sided test, adjusted for false discovery rate.
↵† Weighted to represent treatment distribution in population; estimates in the target column are in true metrics of the scales, whereas estimates in the other columns are based on standardized values of the row variables, with mean of 0 and variables of 1.0.
↵‡ Either saw a mental health specialist or referred to mental health treatment.