A mental health brief intervention in primary care: Does it work?

Abstract

Objective In 2005, a district health board in New Zealand established the Mental Health Brief Intervention Service (MHBIS)—a government- funded initiative that allows primary care practitioners (PCPs) to refer patients with mild-to-moderate mental health problems to a mental health clinician for up to 4 sessions per year at no additional cost. Our goal was to evaluate the impact that MHBIS had on primary care practice referrals to secondary mental health services and patient outcomes in New Zealand. Methods cWe used a survey questionnaire and focus groups for primary care physicians, practice nurses, and MHBIS clinicians (nurses, social workers, and an occupational therapist). A total of 49 surveys were returned from a sample of 96 physicians, practice nurses, and MHBIS clinicians. We conducted focus groups with 21 members of the sample. The MHBIS database provided information from 474 referrals. We coded quantitative responses to the questionnaires and entered them directly into the Statistical Package for the Social Sciences program (SPSS) for analysis. We thematically coded data collected in the focus groups and the responses made in the comment section of the questionnaire. The data were transformed into quantitative variables and entered into SPSS for further analysis. Results cMH BIS improved outcomes by facilitating treatment for patients with depression.Physicians prescribed fewer psychotropic drugs and said they did so “more effectively.” In addition, patient use of MH BIS reduced the need for primary care referrals to Secondary Mental Health Services, reserved for patients with severe mental health disorders. Conclusion cThe study supports the use of a collaborative model of care. This approach allows for the effective treatment of mildto- moderate mental disorders by supporting practitioners with a brief intervention in addition to usual care.