Functional concerns and treatment priorities among veterans receiving VHA Primary Care Behavioral Health services.

Introduction: The Primary Care—Mental Health Integration program is a component of the Veterans Health Administration’s patient-centered medical home, which emphasizes comprehensive, patient-centered care. One model of primary care—mental health integration, known as Primary Care Behavioral Health (PCBH), positions trained behavioral health providers as members of the primary care team. Whereas patient perspectives are essential to effective patient-centered care, little empirical information exists regarding patients’ goals and priorities for addressing their biopsychosocial concerns in PCBH. Method: A regional mail survey of Veterans Health Administration patients was used. We collected data from 281 veterans (27% response rate) who received PCBH services in a northeastern region. Results: Respondents identified difficulty with sleep (80%), low energy/amotivation (78%), and managing stress (72%) as the most prevalent individual concerns, although the majority endorsed concerns in multiple domains of functioning. Overwhelmingly, patients who endorsed any biopsychosocial problem area reported that they did (53—93%) or would like to (56—81%) address that concern with a behavioral health provider. Respondents most frequently identified anger as a top priority for future care, followed by stress management, energy/motivation, and sleep disturbance. Whereas sample means signaled neutral or better quality of life in most individual domains, total Quality of Life Inventory scores suggested very low (32%) to average (30%) overall quality-of -life ratings for most participants. Discussion: In addition to symptom-focused PCBH assessments, providers should gather biopsychosocial data to identify and monitor functional and quality-of -life concerns and evaluate patient preferences in addressing these concerns over the course of clinical care. (PsycINFO Database Record (c) 2019 APA, all rights reserved)