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Addressing Health Care Disparities for People Managing Serious Mental Illness: A Proposed Model and Case Report

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Abstract

There are significant health care disparities for people who manage serious mental illnesses, especially in screening and preventive care. Often symptoms and behaviors associated with anxiety interfere with effective health communication. Fear and avoidance of medical procedures are common barriers to accessing preventive health services. This case report demonstrates a model that effectively empowered a patient who manages a serious mental illness to participate in preventive care. This case illustrates a 4-step, easy to remember model with the acronym “VARI”: (1) Validate the patient’s experience, (2) Acknowledge the patient’s right to make their own decisions, (3) provide a collaborative, individualized Risk assessment for screening and preventive services and (4) provide Integrated mental and medical health care to address treatment-interfering symptoms. In this case example, the model was effective. The need for subsequent research regarding feasibility, safety, generalizability and efficacy of this model for addressing disparities in this population is discussed.

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Acknowledgements

The authors would like to thank Elizabeth Ezell, PA-C, for developing many of the practices that generated the VARI model.

Funding

This work is supported with resources and the use of facilities at the Minneapolis VA Healthcare System. The contents do not represent the views of the U.S. Department of Veterans Affairs or the United States Government.

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Authors and Affiliations

  1. Edith Nourse Rogers Memorial Veterans Hospital, 200 Springs Road, Building 9, Mailstop 116A, Bedford, MA, 01730, USA

    J. Irene Harris, Jay A. Gorman & Arielle A. J. Scoglio

  2. University of Minnesota Medical School, Minneapolis, MN, USA

    J. Irene Harris

  3. VISN 1 Mental Illness Research, Education, and Clinical Center, Bedford, MA, USA

    J. Irene Harris & Jay A. Gorman

  4. Allina Health West St. Paul Clinic, West St Paul, MN, USA

    Mary Grove & Kayla N. Gillispie

  5. Boston University School of Medicine, Boston, MA, USA

    Jay A. Gorman

  6. Institute for Health Equity and Social Justice Research, Northeastern University, Boston, MA, USA

    Arielle A. J. Scoglio

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  1. J. Irene Harris
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  2. Mary Grove
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  3. Kayla N. Gillispie
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  4. Jay A. Gorman
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Correspondence to J. Irene Harris.

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Harris, J.I., Grove, M., Gillispie, K.N. et al. Addressing Health Care Disparities for People Managing Serious Mental Illness: A Proposed Model and Case Report. J. Psychosoc. Rehabil. Ment. Health 7, 77–83 (2020). https://doi.org/10.1007/s40737-020-00156-x

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  • DOI: https://doi.org/10.1007/s40737-020-00156-x

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