Transforming Mental Health Initiative, a primary care behavioral health integration program at several clinics throughout San Diego, aims to increase access to timely behavioral health treatment. The program uses warm hand-offs where referring providers share information with mental health therapist during primary care visits to help facilitate referrals. When warm hand-offs were not feasible, the Centralized Access and Triage team (CAT) was developed to reach out to patients by phone and explain the services provided by the program. This study evaluated the association between types of first contact method and initial appointment scheduling outcomes.
Patients in this study received a referral for mental health services at integrated primary care locations. Data were collected through electronic health record abstraction and analyzed using Chi2, Wilcoxon rank-sum, and logistic regression.
317 patients with warm hand-offs and 86 CAT contacted patients were instructed to schedule an initial assessment. 82.6% of warm hand-off and 89.5% of CAT patients scheduled an initial assessment and 85.9% and 83.1% completed their initial assessment, respectively. Median days from referral to initial appointment was 14 (6,27) for warm hand-off and 15 (8,22) for CAT patients. None of these differences were statistically significant.
We found outreach by care coordinators was as effective as warm hand-offs for patient scheduling and completing initial appointments. Further research is needed to better understand the clinical benefits of the warm hand-off, particularly in pediatric patients, to determine if there are other benefits beside patient scheduling and initial appointment adherence.
