(Aug. 22, 2018) Individuals with serious mental illness have chronic physical conditions at rates significantly higher than the general population, such as cardiovascular disease and diabetes, and are less likely to receive standard levels of care for these conditions. This disparity contributes to the extreme lower life expectancy of individuals with serious mental illness, causing them to die up to 32-years sooner than those without mental illness, according to most recent estimates.
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| Photo courtesy of David Herrera |
An increased effort to integrate physical health care into community mental health clinics is aimed at addressing this concern. In January 2013, Kitsap Mental Health Services, a community mental health center in Kitsap County, Washington, received a Centers for Medicare and Medicaid Innovation Award to implement a program called Race for Health! The program utilizes a whole health model that addresses all an individual's health needs, including psychiatric and physical health conditions.
Kitsap Mental Health Services restructured their staff into multidisciplinary care teams, each including a psychiatrist, psychiatric nurse, therapists, case managers and co-occurring disorder specialists. These teams worked together to address the patient's whole health and develop a treatment plan. In addition, well-being interventions were developed, aimed at helping patients reduce tobacco use and increase physical activity.
In a newly-published article in Psychiatric Services this week, Ellen Bouchery and her co-authors analyze the effects of the whole health model, Race for Health! on reducing Medicare expenditures and health care utilization among individuals with mental illness.
Integrated care reduces costs
The authors found that the integrated care model reduces Medicare expenditures by $266 per month per enrollee in the program, compared to participants in another community mental health center. The cost savings were due to a decrease in hospitalizations, emergency department visits and outpatient office appointments among the individuals enrolled.
The program's success is attributable to the mental health treatment staff having greater awareness for their patient's general medical needs and their coordination with their patient's primary care physicians, the authors report.
Although the study did not allow for an analysis of the whole health model on improving long-term outcomes, the results suggest that integrating physical health care into community mental health centers may improve care access to individuals with serious mental illness with co-occurring conditions. These innovative models will hopefully improve outcomes and longevity, addressing the extreme disparity in mortality among individuals from this vulnerable population.
Elizabeth Sinclair
Director of Research
References:
- Bouchery, E. et al. (2018, August). Implementing a whole health model in a community mental health center: Impact on service utilization and expenditures. Psychiatric Services.