Psychiatric Multimorbidity in a Specialized Program for Severely Mentally Ill Veterans

Area of Science:

• Psychiatry
• Health Services Research

Background:

• Psychiatric multimorbidity may be a more accurate descriptor for severely impaired patients than single diagnoses.
• Integrated, co-located psychiatric and social services may offer better care for these patients compared to conventional one-to-one settings.

Purpose of the Study:

• To test the hypothesis that multimorbidity is a key characteristic of Veterans treated at an integrated, multi-service program.
• To compare veterans using integrated services with those in standard outpatient clinics.

Main Methods:

• Utilized administrative data from the VA Connecticut Health Care System (FY 2012).
• Compared veterans at the Errera Community Care Center (ECCC) with those in standard outpatient clinics.
• Employed bivariate and multiple logistic regression analyses.

Main Results:

• 20.6% of 11,092 veterans received care at the ECCC.
• Multivariable analysis linked ECCC treatment to younger age, lower income, homelessness, and significant psychiatric multimorbidity (multiple substance use and psychiatric diagnoses).

Conclusions:

• Veterans in integrated care settings exhibit high levels of psychiatric multimorbidity.
• The term 'psychiatric multimorbidity' may have greater clinical relevance for characterizing patients in programs addressing severe mental illness and homelessness.
• Further research is needed to evaluate the effectiveness of integrated "one-stop shop" treatment models.