Are mental health treatment more effective when separate or when integrated into treatment of physical health?

Briefly describe a specific question, or set of related questions, about a health care test or treatment that this program should consider.: Are mental health treatment more effective when separate or when integrated into treatment of physical health?
Does your question include a comparison of different health care approaches? (If no, your topic will still be considered.): yes
If yes, explain the specific technologies, devices, drugs, or interventions you would like to see compared:: Mental health services have been carved out of basic health care and are managed separately. Is this the most effective approach for the patient's care or would it be wise to integrate the care management?
What patients or group(s) of patients does your question apply to? (Please include specific details such as age range, gender, coexisting diagnoses, and indications for therapy.): patients receiving mental health services, all ages and gender.
Are there subgroups of patients that your question might apply to? (For example, an ethnic group, stage or severity of a disease.): unknown
Describe the health-related benefits you are interested in. (For example, improvements in patient symptoms or problems from treatment or diagnosis.): Minimizing the number of provider visits; coordination of care between providers.
Describe any health-related risks, side effects, or harms that you are concerned about.: none

Does your question include a health care drug, intervention, device, or technology available (or likely to be available) in the U.S.?

yes

Which priority area(s) and population(s) does this topic apply to? (check all that apply)

EHC Priority Conditions (updated in 2008)

AHRQ Priority Populations

Low income groups
Minority groups
Women
Children
Elderly
Individuals with special health care needs, including individuals with disabilities or who need chronic care or end-of-life health care

Federal Health Care Program

Describe why this topic is important.: Mental health treatment is often provided in a manner that excludes the provider of other health care. The patient is required to manage both situations without benefit of provider integration of information and planning.
What specifically motivated you to ask this question? (For example, you are developing a clinical guideline, working with a policy with large uncertainty about the appropriate approach, costly intervention, new research you have read, items in the media you may have seen, a clinical practice dilemma you know of, etc.): I have recently been diagnosed with a progressive neurological disease and depression. The providers have purposely avoided the diagnosis that is not in there skill set and refuse to communicate with each other outside of sending visit notes. Depression is common with my disease, and certainly is within the purview of all providers to discuss the situation with me and each other. I am a health care provider myself, understand the system, and still have been unable to obtain integrated care. Reimbursement systems complicate the situation further.
Does your question represent uncertainty for clinicians and/or policy-makers? (For example, variations in clinical care, controversy in what constitutes appropriate clinical care, or a policy decision.): yes
If yes, please explain:: unsure, but this would affect payers and providers

How will an answer to your research question be used or help inform decisions for you or your group?: Improve the overall effectiveness of mental health services.
Describe the timeframe in which an answer to your question is needed.: as soon as possible.
Describe any health disparities, inequities, or impact on vulnerable populations your question applies to.: the lack of mental health services for lower income and for those who cannot force the health care system to serve them are most affected by the lack of integration of care. Rural residents are more affected due to the lack of available services.

Other Information About You: (optional)

Please choose a description that best describes your role or perspective: (you may select more than one category if appropriate): Improve the overall effectiveness of mental health services.

Are you making a suggestion as an individual or on behalf of an organization?: Individual

Effective Health Care Program