Advertisement

Perceived Barriers to and Facilitators of Engagement in Reverse Integrated Care

  • Hillary A. Gleason
  • Debbie Truong
  • Kathleen Biebel
  • Marie Hobart
  • Monika Kolodziej
Article

Individuals with chronic mental illness and addiction have poorer health outcomes than the general population, largely because of preventable medical conditions.1,2 Early onset and heightened incidence of chronic disease—such as type two diabetes, chronic obstructive pulmonary disease, and hypertension—might limit behavioral health consumers’ quality life years and ultimately lead to early mortality.3,4 These health risks are exacerbated by coinciding poor health correlates such as low socioeconomic status, disrupted cycles of care, and substance use.4,5Primary and Behavioral Health Care Integration (PBHCI) initiatives address these compounding health disparities by improving access to quality primary care and wellness services inside of behavioral health centers. As opposed to traditional integrated care models in which behavioral health services are co-located in medical settings, reverse integration targets consumers with serious and persistent mental illness who are more likely...

Keywords

Behavioral Health Community Mental Health Center Active Consumer Behavioral Health Care Persistent Mental Illness 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Acknowledgments

We thank all the members of the Wellness Team at Community Healthlink, both past and present, for the dedication, passion, and creativity they have brought to the Wellness Center.

Compliance with Ethical Standards

Funding

The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: The Substance Abuse and Mental Health Services Administration awarded a Primary and Behavioral Health Care Initiative grant in September 2010.

Conflict of Interest

The authors declare no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

References

  1. 1.
    Colton CW, & Manderscheid RW. Congruencies in increased mortality rates, years of potential life lost, and causes of death among public mental health clients in eight states. Preventing Chronic Disease. 2006; 3(2): 1–14.Google Scholar
  2. 2.
    Druss BG, Zhao L, Esenwein SV, et al. Understanding excess mortality in persons with mental illness. Medical Care. 2011; 49(6): 599–604.CrossRefPubMedGoogle Scholar
  3. 3.
    Brunero S, Lamont S, & Fairbrother, G. Prevalence and predictors of metabolic syndrome among patients attending an outpatient clozapine clinic in Australia. Archives of Psychiatric Nursing 2009; 23(3): 261–268.CrossRefPubMedGoogle Scholar
  4. 4.
    National Association of State Mental Health Program Directors (NASMHPD). Morbidity and mortality in people with serious mental illness. Alexandria: NASMHPD, 2006.Google Scholar
  5. 5.
    Dewa CS, Tugg L, Ghavam-Rassoul A, et al. Examining factors associated with primary care and continuity of care among adults with severe mental illness. Journal of Contemporary Psychotherapy. 2012; 42(1): 45–54.CrossRefGoogle Scholar
  6. 6.
    Scharf DM, Eberhart NK, Schmidt N, et al. Integrating primary care into community behavioral health settings: Programs and early implementation experiences. Psychiatric Services. 2013; 64(7): 660–665.CrossRefPubMedGoogle Scholar
  7. 7.
    Kiraly B, Gunning K, & Leiser J. Primary care issues in patients with mental illness. American Family Physician. 2008; 78(3): 355–62.PubMedGoogle Scholar
  8. 8.
    McCabe MP, & Leas L. A qualitative study of primary health care access, barriers and satisfaction among people with mental illness. Psychology, Health & Medicine. 2008; 13(3): 303–312.CrossRefGoogle Scholar
  9. 9.
    Druss BG. Improving medical care for persons with serious mental illness: challenges and solutions. Journal of Clinical Psychiatry. 2007; 68(Suppl 4): 40–44.PubMedGoogle Scholar
  10. 10.
    Glover CM, Ferron JC, & Whitley R. Barriers to exercise among people with severe mental illness. Psychiatric Rehabilitation Journal. 2013; 36(1): 45–47.CrossRefPubMedGoogle Scholar
  11. 11.
    Chadwick A, Street C, McAndrew S, et al. Minding our own bodies: reviewing the literature regarding the perceptions of service users diagnosed with serious mental illness on barriers to accessing physical health care. International Journal of Mental Health Nursing. 2012; 21, 211–219.CrossRefPubMedGoogle Scholar
  12. 12.
    Miller CL, Druss BG, Dombrowski EA, et al. Barriers to primary care among patients at a community mental health center. Psychiatric Services. 2003; 54(8): 1158–1160.CrossRefGoogle Scholar
  13. 13.
    Marchinko S, & Clarke D. The wellness planner: empowerment, quality of life, and continuity of care in mental illness. Archives of Psychiatric Nursing. 2011; 25(4): 284–293.CrossRefPubMedGoogle Scholar
  14. 14.
    Alzri MH, & Neal RD. The association between satisfaction with services provided in primary care and outcomes in type 2 diabetes mellitus. Diabetic Medicine. 2003; 20(6): 486–490.CrossRefGoogle Scholar
  15. 15.
    Barrett BM, Young MS, Teague GB, et al. Recovery orientation of treatment, consumer empowerment, and satisfaction with services: a mediational model. Psychiatric Rehabilitation Journal. 2010; 34(2): 153–156.CrossRefPubMedGoogle Scholar
  16. 16.
    Bleich SN, Özaltin E, & Murray CJL. How does satisfaction with the health-care system relate to patient experience? Bulletin of the World Health Organization. 2009; 87(4): 271–278.CrossRefPubMedPubMedCentralGoogle Scholar
  17. 17.
    Substance Abuse and Mental Health Administration (SAMHSA) Center for Mental Health Services National Outcome Measures (NOMs) report guide for PBHCI, version 1. Rockville: SAMHSA, 2010.Google Scholar
  18. 18.
    Hsieh H, & Shannon SE. Three approaches to qualitative content analysis. Qualitative Health Research. 2005; 15(9): 1277–1288.CrossRefPubMedGoogle Scholar
  19. 19.
    Justine M, Azizan A, Hassan V, et al. Singapore Medical Journal. 2013; 54(10): 581–586.Google Scholar

Copyright information

© National Council for Behavioral Health 2016

Authors and Affiliations

  • Hillary A. Gleason
    • 3
  • Debbie Truong
    • 1
    • 2
  • Kathleen Biebel
    • 2
  • Marie Hobart
    • 1
  • Monika Kolodziej
    • 2
  1. 1.Community HealthlinkWorcesterUSA
  2. 2.Department of PsychiatryUMass Medical SchoolWorcesterUSA
  3. 3.Clinical PsychologyUniversity of MontanaMissoulaUSA

Personalised recommendations