Integrating Mental Health into a Primary Care System: A Hybrid Simulation Model

Depression and anxiety appear to be the most frequently encountered psychiatric problems in primary care patients. It has been also reported that primary care physicians under-diagnose psychiatric illness in their patients. Although collaborative care has been shown to be a cost-effective strategy for treating mental disorders, to the best of our knowledge few attempts of modelling collaborative care interventions in primary care are known in literature. The main purpose of this paper is to propose a hybrid simulation approach to model the integration of the collaborative care for mental health into the primary care pathway in order to allow an accurate cost-effectiveness analysis. Quantitative analysis are reported exploiting different and independent input data sources in order to overcome the problem of the data appropriateness. The analysis demonstrates the capability of the collaborative care to reduce the usual general practitioner overcrowding and to be cost-effective when the psychological treatments have a success rate around the 50%.