Primary care continuity helps teenagers transition to adult mental health care

  • JAMA Netw Open

  • International Clinical Digest
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Takeaway

  • Adolescents with severe mental illness who continued to see their primary care physician (PCP) as they transitioned to adult mental health care had significantly lower rates of mental health-related hospitalizations and emergency department (ED) visits than those who discontinued seeing their PCP or those who had no PCP.

Why this matters

  • Continuity of access to PCPs could improve the long-term outcomes for mental health patients as they transition from adolescence to early adulthood.

Study design

  • Population-based cohort study included 8409 adolescents (age, 12-16 years) with a history of hospitalization >72 hours for a severe mental illness.
  • Funding: Ontario Ministry of Health and Long-Term Care.

Key results

  • During the transition period, 65.1% of adolescents received continuous primary care, 28.4% received discontinuous primary care, and 6.4% received no primary care.
  • Higher rates of mental health-related admissions were noted in adolescents receiving:
    • discontinuous primary care (adjusted relative rate [aRR], 1.20; 95% CI, 1.10-1.30);
    • no primary care (aRR, 1.30; 95% CI, 1.08-1.56).
  • Higher rates of mental health-related ED visits were noted with discontinuous primary care (aRR, 1.16; 95% CI, 1.08-1.26).

Limitations

  • Limited generalizability of findings.

Coauthored with Chitra Ravi, MPharm