Skip to main content

Providing Effective Primary Care for Patients with Serious Mental Illness: Additional Components to Enhance Practice


Despite pronounced disparities in mortality and physical health outcomes, no well accepted models exist for integrating primary care with behavioral health for patients with serious mental illness (SMI). This article describes a case study of an enhanced approach to primary care that builds on the patient centered medical home (PCMH) model and adds three additional components: (1) longer and more frequent visits to establish trust and increase adherence, (2) a primary care team that has both the skills to provide effective primary care and the heart to take care of patients with SMI and (3) planned and proactive communication between the behavioral health team and the primary care team.

This is a preview of subscription content, access via your institution.


  1. Altschuler, J., Margolius, D., Bodenheimer, T., & Grumbach, K. (2012). Estimating a reasonable panel size for primary care physicians with team based task delegation. Annals of Family Medicine,10(5), 396–400.

    Article  Google Scholar 

  2. Archer, J., Bower, P., Gilbody, S., Lovell, K., Richards, D., Gask, L., et al. (2012). Collaborative care for depression and anxiety problems. The Cochrane Database of Systematic Reviews.

    Article  PubMed  Google Scholar 

  3. Druss, B. G., Chwastiak, L., Kern, J., Parks, J. J., Ward, M. C., & Raney, L. E. (2018). Psychiatry’s role in improving the physical health of patients with serious mental illness: A report from the American Psychiatric Association. Psychiatric Services,69(3), 254–256.

    Article  Google Scholar 

  4. Foster, A., Gable, J., & Buckley, J. (2012). Homelessness in schizophrenia. Psychiatric Clinics of North America,35(3), 717–734.

    Article  Google Scholar 

  5. Jackson, G.L., Powers, B.J., Chatterjee, R., Prvu Bettger, J.P., Kemper, A.R., Hasselblad, V.,…,Williams, J.W. (2013). Improving patient care. The patient centered medical home. A systematic review. Annals of Internal Medicine258(3) 169–78,

  6. Miller, B. J., Paschall, C. B., & Svendsen, D. P. (2006). Mortality and medical comorbidity in people with serious mental Illness. Psychiatric Services,57(10), 1482–1487.

    Article  Google Scholar 

  7. Olfson, M., Gerhard, T., Huang, C., Crystal, S., & Stroup, T. S. (2015). Premature Mortality Among Adults With Schizophrenia in the United States. The Journal of the American Medical Association Psychiatry,72(12), 1172–1181.

    PubMed  Google Scholar 

  8. Perrin, J., Reimann, B., Capobianco, J., Wahrenberger, J. T., Sheitman, B. B., & Steiner, B. D. (2018). A model of enhanced primary care for patients with serious mental illness. North Carolina Medical Journal,79(4), 240–244.

    Article  Google Scholar 

  9. Raney, L. E., Lasky, G. B. (2017). The primary care provider (Chap. 5). In: Integrated care: A guide for effective implementation (pp. 153–154.) Arlington, VA: American Psychiatric Association Services.

    Google Scholar 

  10. Scharf, D. M., Eberhart, N. K., Schmidt, N., Vaughan, C. A., Dutta, T., Pincus, H. A., et al. (2013). Integrating primary care into community behavioral health settings: Programs and early implementation experiences. Psychiatric Services,64(7), 660–665.

    Article  Google Scholar 

Download references

Author information



Corresponding author

Correspondence to Beat Daniel Steiner.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Steiner, B.D., Wahrenberger, J.T. & Raney, L. Providing Effective Primary Care for Patients with Serious Mental Illness: Additional Components to Enhance Practice. Community Ment Health J 56, 592–596 (2020).

Download citation


  • Integrated care
  • Serious mental illness
  • Primary care