When Help Becomes a Hindrance: Mental Health Referral Systems as Barriers to Care for Primary Care Physicians Treating Patients With Alzheimer's Disease

PCPs viewed problems created by onerous referral systems, such as mental health carve outs, as particularly burdensome for elderly patients with comorbid dementia and neuropsychiatric problems. These problems were cited by PCPs across different types of practice settings. PCPs managed treatment of neurobehavioral symptoms as best they could despite lack of specialist support.