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Primary care doctors OK for PTSD, depression in military members: Study

By Stephen Feller

SANTA MONICA, Calif., June 14 (UPI) -- Increasing access to psychological services through primary care physicians resulted in members of the military having better mental health, according to a recent U.S. Department of Defense-funded study.

Researchers at the RAND Corporation report providing care managers and telemedicine options for care to service members with post-traumatic stress disorder or depression decreased symptoms of the conditions.

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Tested as a method of removing the stigma from seeking mental healthcare, the researchers enhanced an already-used method in the U.S. Army that regularly screens service members and follows up to coordinate care with primary and secondary providers such as mental health professionals.

Expanding the program to bring more aspects of mental healthcare to clinics on military bases shows an improvement in the mental conditions of their patients, researchers report.

"The results support the idea that high-quality mental health care can be provided in primary care settings," Dr. Charles Engel, a senior natural scientist at RAND, said in a press release. "While many military members are reluctant to seek out mental health specialists, they are more willing to receive primary medical care."

For the study, published in JAMA Internal Medicine, researchers randomly assigned 666 service members at six on-base U.S. Army medical clinics to receive 12 months of either standard psychological treatment through their primary care physician or enhanced psychosocial and pharmacologic treatment.

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Included in the enhanced treatment was access to mental health professionals in their doctor's office, as well as telephone-based cognitive-behavioral therapy, nurse care managers and online self-management programs.

Overall, 25 percent of service members with PTSD treated with the enhanced program reported a 50 percent improvement in their symptoms, compared to just 17 percent for those for standard treatment. For patients with depression, 30 percent of those in the enhanced program reported a 50 percent improvement in symptoms, as opposed to 20 percent with standard treatment.

"Although the improvements were modest, the reach of the program can be large and has the potential to bring more people under a high-quality treatment umbrella sooner," Engel said. "These findings suggest that the military health system might use this strategy to extend the reach of mental health care and reduce time to first treatment for PTSD and depression."

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