Author ORCID Identifier

Defense Date


Document Type


Degree Name

Master of Science



First Advisor

Dr. Bruce Rybarczyk


Many mental health (MH) needs go unidentified in primary care, and certain patients appear to be at higher risk of needs going unidentified and subsequently untreated. Little is known about patterns of detection and treatment in clinics with integrated mental health services. The purpose of this study was to characterize the prevalence of MH needs and evaluate patient characteristics as predictors of both the presence of a MH need and type of MH services received. Subjects were patients receiving care at two safety net primary care clinics with integrated mental health services (N=816; 52.7% Latinx, 15.9% African American), and were classified as either having received integrated MH services in the previous year or as not. Sociodemographic and medical information was extracted from all medical records, and patients who had not received integrated MH services completed a MH needs assessment. The prevalences for depression, suicidal ideation, anxiety and PTSD were within expected ranges. Surprisingly, patient characteristics did not predict the presence of a MH need, though several characteristics predicted the type of MH treatment received. Patients were less likely to receive integrated MH services if they were older (χ2(1) = 7.36, p= .007), Hispanic/Latinx (χ2(1) = 7.97, p= .005), and/or partnered (χ2(1) = 20.65, p= .000). This study suggests that biases in detection of MH needs in integrated primary care may be less pronounced than in non-integrated primary care. However, longstanding disparities in MH treatment may persevere in this newer model of primary care.


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