Behavioral Health Services Influence Medical Treatment Utilization Among Primary Care Patients with Comorbid Substance Use and Depression

  • Benjamin I. FellemanEmail author
  • Dylan R. Athenour
  • Minhdan T. Ta
  • David G. Stewart


Although research has shown benefits of integrating psychological care in primary care settings, it is unclear how this form of treatment impacts individuals with comorbid substance use and depression. The findings are also mixed concerning how frequently this comorbid population seeks primary care services. This study examined the associations between substance use, depression, and medical treatment utilization among 224 primary care patients. The aim of the investigation was twofold. First, to determine if depression increases medical treatment utilization among patients with substance use disorders; second, to evaluate if behavioral health treatment reduces medical service utilization. A moderated mediation model with bootstrapping analyses revealed that depression strengthened the relationship between substance use and primary care treatment utilization (both medical and behavioral health). The model also indicated that behavioral health services were associated with fewer primary care visits for individuals with comorbid substance use and depression. Clinical and social implications are discussed.


Behavioral health Substance use Depression Primary-care 



The authors wish to thank Melissa Baker for her assistance with this research.


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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Benjamin I. Felleman
    • 1
    Email author
  • Dylan R. Athenour
    • 1
  • Minhdan T. Ta
    • 1
  • David G. Stewart
    • 1
  1. 1.Department of Clinical PsychologySeattle Pacific UniversitySeattleUSA

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