Establishing an Integrated Health Care Clinic in a Community Mental Health Center: Lessons Learned
Integrating primary care with behavioral health services at community mental health centers is one response to the disparity in mortality and morbidity experienced by adults with serious mental illnesses and co-occurring substance use disorders. Many integration models have been developed in response to the Primary and Behavioral Health Care Integration (PBHCI) initiative of the Substance Abuse and Mental Health Services Administration (SAMHSA). One model is a primary care clinic co-located within the mental health center. The Connecticut Mental Health Center (CMHC) Wellness Center is one such co-located clinic developed as a partnership between CMHC and a Federally Qualified Health Center (FQHC). In this article, we describe the process of developing this on-site clinic along with lessons learned during implementation. We review different aspects of building and maintaining such a clinic and outline lessons learned from both successes and challenges. We briefly describe the demographics and health characteristics of the patient population served in this clinic. We make recommendations for providers and agencies that are considering or are already developing a model for integrating care. Finally, we briefly review status of our clinic after completion of grant funding.
KeywordsIntegrated care Co-located care Serious mental illness Medical co-morbidity Medical care of patients with serious mental illness Care coordination Peer health navigators Behavioral health home Community mental health center Federally qualified healthcare center
The authors thank Larry Davidson, Ph.D., for his support of the evaluation team throughout the project and critical review of this manuscript
Compliance with Ethical Standards
The project was funded by Substance Abuse and Mental health Services Administration (SAMHSA) H97SM061007
This work was supported by the Connecticut Department of Mental Health and Addiction Services (DMHAS). But the opinions expressed in this article do not necessarily reflect the views of DMHAS.
Conflict of Interest
The authors declare that they have no competing interests.
All procedures performed in this project were in accordance with the ethical standards of the local Institutional Review Board and with the 1964 Helsinki declaration and its later amendments.
Informed consent was obtained from all participants in this project.
- 5.SAMHSA-HRSA Center for Integrated Health Solutions. Standard framework for levels of integrated healthcare [cited 2015 Jan 11]. Available from: http://www.integration.samhsa.gov/resource/standard-framework-for-levels-of-integrated-healthcare.