What are some of the key elements in clinics that provide medical services to individuals with serious mental illnesses in community mental health settings?

Individuals with serious mental illness have elevated rates of medical comorbidity and early mortality from medical conditions. To address this problem, a growing number of community mental health centers are establishing primary care clinics to improve access and quality to medical care for their patients. These clinics typically are staffed by a prescriber (primary care physician, nurse practitioner, or physician assistant); one or more case manager (most commonly nurse or social worker); and peer specialists or behaviorists to support positive health behavior change.

These clinics typically require enhanced resources and specialized training. First, they benefit from additional time and care by providers, with case loads about half the size of these seen in a typical primary care practice. Second, they provide training for medical providers in working with the SMI population, and training for mental health providers in basic medical issues. Finally, they include structured communication between the primary care team and behavioral health providers, such as regular team meetings and warm handoffs across the teams. Programs incorporating all of these elements have the potential to increase rates of screening and preventative care for medical problems in populations with SMI.

 

REFERENCE

Perrin, J et al. “A model of enhanced primary care for patients with severe mental illness.” North Carolina medical journal 79.4 (2018): 240-244. Grove, LR et al. Effect of Enhanced Primary Care for People with Serious Mental Illness on Service Use and Screening J Gen Intern Med. 2021

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