It’s becoming more common for primary care physicians to treat mental health concerns for their patients, new research shows. But this is more common among White patients.
The study, published in Health Affairs’ February issue, analyzed 109,898 primary care visits between 2006 and 2018. The researchers determined if mental health was listed as the reason for the visit, or if the physician diagnosed a mental health condition during the visit.
The Health Affairs study found that in 2006, 10.7% of primary care visits addressed mental health concerns, compared 15.9% by 2016 and 2018, representing a 50% increase. This percentage was higher, at 16.8%, for patients who saw their own primary care physician.
“Not surprisingly, mental health concerns were significantly more likely to be addressed in a visit with a patient’s usual primary care physician than in a visit with another primary care physician … These findings build on previous work demonstrating the importance of having an ongoing supportive relationship with a usual primary care doctor for addressing the full continuum of patient needs, and mental health needs in particular,” the researchers said.
The study also discovered significant differences based on race and ethnicity. Black patients were 40% less likely to have their mental health concerns addressed than White patients, and Hispanic patients were also 40% less likely to have their mental health concerns addressed than non-Hispanic patients.
More research is needed to determine why this is the case, including whether it’s due to disparities in screening for mental health, differences in access to care or differences in insurance, the researchers said.
Additionally, patients with Medicaid and Medicare were more likely than those with commercial insurance to have their mental health addressed. However, these differences are not all that surprising, the researchers said.
“These differences may be warranted, given evidence that among Medicare beneficiaries with chronic conditions, the presence of depressive symptoms has been associated with increased odds of health care use,” the report stated. And despite covering only 14% of the adult population in 2015, Medicaid covered 21% of adults with a mental illness and 26% of adults with a serious mental illness, the report said.
The increase in primary care physicians addressing mental health calls for policy and care delivery updates so they’re better equipped to provide this care, the report states. This includes improved payment and billing processes, such as value-based care.
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