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Am J Psychiatry 1996; 153:1353-1356
Copyright © 1996 by American Psychiatric Association
Outpatient mental health care in nonhospital settings: distribution of patients across provider groups
M Olfson and HA Pincus
Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA.
OBJECTIVE: A national overview of outpatient mental health care in
nonhospital settings is provided, focusing on the distribution of patients
among psychiatrists, psychologists, general medical physicians, and other
health professionals. METHOD: Data from the household section of the 1987
National Medical Expenditure Survey were analyzed to determine the volume
and characteristics of patients receiving mental health care from these
four professional groups. RESULTS: In 1987 an estimated 4.1% of
noninstitutionalized Americans (9.0 million) made 84 million outpatient
mental health visits to nonhospital settings. Psychiatrists provided
significantly more visits than psychologists for schizophrenia, bipolar
disorder, substance abuse, and depression, but significantly fewer visits
for anxiety disorders and symptoms such as "nervousness." General medical
physicians provided the most visits for adjustment disorders and substance
abuse, while the other professionals provided the most visits for childhood
mental disorders and mental retardation. CONCLUSIONS: In 1987 important
differences existed between the outpatients who received mental health care
from psychologists, psychiatrists, general medical physicians, and other
health professionals.
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