Patient perspectives in addressing mental health needs in primary care

<h3>Context</h3> Primary care physicians often help patients with mental health concerns, but little is known about patients’ views of addressing their mental health needs within the primary care setting. <h3>Objective</h3> We evaluated the change in self-reported progress and confidence among patients identified as having one or more mental health risks who wanted to improve these risks by creating a personal care plan. <h3>Study Design and Analysis</h3> Quantitative study. <h3>Setting or Dataset</h3> The primary data source was My Own Health Report (MOHR). <h3>Population Studied</h3> 29 patients with multiple chronic conditions who chose to create a care plan to improve their mental health (particularly sleep, loneliness, and anxiety/depression). <h3>Intervention</h3> Patients were connected with a patient navigator to help them complete a Health Risk Assessment (HRA) and care planning tool, MOHR. Patients could create a care plan for up to two identified risks. MOHR presented a list of 10-15 actionable evidence-based strategies that patients could select to improve the risk. Patients were asked weekly to record their care plan progress and update their confidence. The navigator then checked in with the patient weekly to provide additional support and guidance. Together, patients and navigators could modify care plans, strategies, and personal goals; complete care plans for risks that had been addressed; and select new care plans for new or unaddressed risks. <h3>Outcome Measures</h3> From MOHR, we determined the change in patients’ progress and confidence at meeting mental health care goals from the beginning to end of care planning. <h3>Results</h3> Patients reported an increase in progress on their mental health care plans from baseline to end of care planning (p = 0.010); particularly among patients who created a sleep care plan (p = 0.010). While there was an increase in average confidence, the increase was not statistically significant (p = 0.297). When analyzed by type of mental health care plan, average confidence increased among patients with loneliness and sleep care plans but decreased among patients with anxiety and depression care plans; however, these results were not statistically significant. <h3>Conclusions</h3> Care planning can be an effective tool for engaging patients to improve their mental health. Additional research is needed to understand the modifiable factors associated with patients feeling less confident in addressing mental health topics such as anxiety and depression in primary care.