--- title: "Two-minute mental health care for elderly patients: inside primary care visits. | Sutter Health" description: "Mental health topics occurred in 22% of visits, although pt survey indicated that 50% of pts were depressed. A mental health discussion lasted 2 minutes." url: "https://www.sutterhealth.org/research/publications/two-minute-mental-health-care-for-elderly-patients-1055312643" --- 1. [Home](https://www.sutterhealth.org/) / 2. [Research](https://www.sutterhealth.org/research) / 3. [Research publications](https://www.sutterhealth.org/research/publications) / 4. Two-minute mental health care for elderly patients: inside primary care visits. # Two-minute mental health care for elderly patients: inside primary care visits. Tai-Seale M, McGuire T, Colenda C, Rosen D, & Cook MA. _J Am Geriatr Soc. 55(12):1903-11._ 2007-12-01 ## Abstract OBJECTIVES: To assess how care is delivered for mental disorders using videotapes of office visits involving elderly patients. DESIGN: Mixed-method observational analysis of the nature of the topics discussed, content of discussion, and the time spent on mental health. SETTINGS: Three types of settings: an academic medical center, a managed care group, and fee-for-service solo practitioners. PARTICIPANTS: Thirty-five primary care physicians and 366 of their elderly patients. MEASUREMENTS: Videotapes of 385 visits covering 2,472 diverse topics were analyzed. Coding of the videotapes identified topics, determined talk time, and coded the dynamics of talk. RESULTS: Mental health topics occurred in 22% of visits, although patient survey indicated that 50% of the patients were depressed. A typical mental health discussion lasted approximately 2 minutes. Qualitative analysis suggested wide variations in physician effort in providing mental health care. Referrals to mental health specialists were rare even for severely depressed and suicidal patients. CONCLUSION: Little time is spent on mental health care for elderly patients despite heavy disease burdens. Standards of care based on a count of visits "during which a mental health problem is discussed" may need to be supplemented with guidelines about what should happen during the visit. System-level interventions are needed. [PubMed abstract](http://www.ncbi.nlm.nih.gov/pubmed/18081668) ## Research topics - [Aging and Longevity](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Aging+and+Longevity%5C%22%22) - [Health Services](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Health+Services%5C%22%22) - [Mental Health](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Mental+Health%5C%22%22) ## Related publications [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) - Publication ### [New Era Of Patient Engagement](https://www.sutterhealth.org/research/publications/new-era-of-patient-engagement-1055312777) Tai-Seale M. Health Affairs website. 2013 Feb 06 - Publication ### [Expressing uncertainty in clinical interactions between physicians and older patients: what matters?](https://www.sutterhealth.org/research/publications/expressing-uncertainty-in-clinical-interactions-1055312608) Tai-Seale M, Stults C, Zhang W, Shumway M. Patient Educ Couns. 86(3):322-8. doi: 10.1016/j.pec.2011.06.005. Epub 2011 Jul 20. 2012 Mar 01 - Publication ### [How do primary care physicians respond when patients cry during routine ambulatory visits?](https://www.sutterhealth.org/research/publications/how-pcps-respond-when-pts-cry-in-outpt-visits-1055312766) Stults CD, Elston Lafata J, Diamond L, MacLean L, Stone AL, Wunderlich T, Frankel RM, Tai-Seale M. J Comm Healthcare. 7(1):17-24. DOI: http://dx.doi.org/10.1179/1753807614Y.0000000044 2014 Mar 01 - Publication ### [Three types of ambiguity in coding empathic interactions in primary care visits: implications for research and practice.](https://www.sutterhealth.org/research/publications/ambiguity-in-coding-empathic-interactions-in-pc-1055312573) Stone A, Tai-Seale M, Stults C, Luiz J, Frankel R. Patient Educ Couns. 89(1):63-8. doi: 10.1016/j.pec.2012.06.013. Epub 2012 Jul 17. 2012 Oct 01 - Publication ### [Understanding primary care physicians' propensity to assess elderly patients for depression using interaction and survey data.](https://www.sutterhealth.org/research/publications/pcp-propensity-assess-sr-pts-depression-1055312561) Tai-Seale M, Bramson R, Drukker D, Hurwicz ML, Ory M, Tai-Seale T, Street R Jr, Cook MA. Med Care. 43(12):1217-24. 2005 Dec 01 [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) ```json {"@context":"https://schema.org","@type":"MedicalOrganization","name":"Sutter Health","@id":"https://www.sutterhealth.org/#medicalorganization","url":"https://www.sutterhealth.org","logo":"https://www.sutterhealth.org/static/images/sutter-health-logo.svg","address":{"@type":"PostalAddress","streetAddress":"2200 River Plaza Drive","addressLocality":"Sacramento","addressRegion":"CA","postalCode":"95833","addressCountry":"US"},"areaServed":{"@type":"AdministrativeArea","name":"California"},"sameAs":["https://www.facebook.com/SutterHealth","https://www.instagram.com/sutterhealth/","https://x.com/SutterHealth","https://www.youtube.com/sutterhealth","https://www.linkedin.com/company/sutter-health","https://en.wikipedia.org/wiki/Sutter_Health"]} ``` ```json {"@context":"https://schema.org","@type":"BreadcrumbList","@id":"https://www.sutterhealth.org/research/publications/two-minute-mental-health-care-for-elderly-patients-1055312643#breadcrumblist","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https://www.sutterhealth.org/"},{"@type":"ListItem","position":2,"name":"Research","item":"https://www.sutterhealth.org/research"},{"@type":"ListItem","position":3,"name":"Research publications","item":"https://www.sutterhealth.org/research/publications"},{"@type":"ListItem","position":4,"name":"Two-minute mental health care for elderly patients: inside primary care visits."}]} ``` ```json {"@context":"https://schema.org","@type":"MedicalScholarlyArticle","@id":"https://www.sutterhealth.org/research/publications/two-minute-mental-health-care-for-elderly-patients-1055312643#medicalscholarlyarticle","name":"Two-minute mental health care for elderly patients: inside primary care visits.","headline":"Two-minute mental health care for elderly patients: inside primary care visits.","abstract":"OBJECTIVES: To assess how care is delivered for mental disorders using videotapes of office visits involving elderly patients. 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