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Specialist/Generalist Division of Responsibility for Patients With Mental Disorders
Darrel A. Regier, MD, MPH;
Irving D. Goldberg, MPH;
Barbara J. Burns, PhD;
Janet Hankin, PhD;
Edwin W. Hoeper, MD;
Gregory R. Nycz
Arch Gen Psychiatry. 1982;39(2):219-224.
Abstract
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• The division of responsibility between general medical staff and mental health specialists for care of persons with medical record diagnoses of mental disorders is documented in four organized health care settings. Rates of mental disorders identified in all departments ranged from 35.6 to 122.8 per 1,000 population. Specialty mental health departments treated most severe psychotic and personality disorders, plus transient situational disturbances, whereas neurotic, childhood behavior, and psychophysiological disorders received as much or greater attention in general medical departments. Mental disorder diagnoses were associated with greater patient use of general medical departments. However, joint specialty mental health/ general medical treatment of these patients was associated with lower general medical department visit rates in all settings. Such joint care was facilitated by the low average visit frequency use of mental health departments (2.2 to 8.9 visits per patient per year).
Author Affiliations
From the Office of the Director (Dr Regier), Applied Biometrics Research Branch (Mr Goldberg), and Primary Care Research Section (Dr Burns), Division of Biometry and Epidemiology, National Institute of Mental Health, Rockville, Md; Research and Development Center, Johns Hopkins University, Baltimore (Dr Hankin); Marshfield Clinic and St Joseph's Hospital, Marshfield, Wis (Dr Hoeper); and Marshfield (Wis) Medical Foundation (Mr Nycz).
Footnotes
Accepted for publication Aug 5, 1981.
Reprint requests to National Institute of Mental Health, Room 18C-26, 5600 Fishers Lane, Rockville, MD 20857 (Dr Regier).
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