Care integration goes Beyond Co-Location: Creating a Medical Home

Area of Science:

• Health Services Research
• Psychiatry
• Primary Care Medicine

Background:

• Serious mental illness (SMI) is associated with significant morbidity and premature mortality.
• Integrating mental health and primary care is vital for improving outcomes in SMI populations.
• Co-location of services is a common strategy, but its effectiveness requires further investigation.

Purpose of the Study:

• To investigate the integration of mental health and primary care services within a community mental health center (MHC).
• To explore the experiences and perceptions of MHC staff, PCC staff, and MHC clients regarding co-located services.
• To identify key factors contributing to successful care integration beyond initial co-location.

Main Methods:

• Qualitative focus groups and quantitative online surveys were employed.
• Participants included MHC staff (clinical, non-clinical, leadership), PCC staff, and MHC clients not using the PCC.
• Data were collected one and two years post-implementation of co-located services.

Main Results:

• MHC staff initially reported limited awareness and expectations of the co-located primary care center (PCC).
• Successful integration requires more than co-location; peer health navigation was identified as beneficial.
• Enhanced integration necessitates improved communication across medical records and inter-agency providers.

Conclusions:

• Care integration for SMI populations benefits from co-location and robust communication.
• Beyond consultation, coordination, and collaboration, co-location and communication are essential 'C's for integration.
• Developing a medical home model requires seamless communication and integrated services.