Reverse Integration Pilot in a Public Safety-Net Hospital’s Outpatient Behavioral Health Clinic

Individuals with severe mental illness are at a higher risk for medical illness and premature death and yet receive poorer quality healthcare. Often mental healthcare is the only care this population receives, thus models of integration are being explored. This study examined medical outcomes and care utilization patterns among patients at an outpatient behavioral health center where primary care was integrated with psychiatric and behavioral healthcare. A retrospective chart review of patients seen at the clinic both for mental and primary healthcare was performed and 147 patients were monitored over the course of one year. While medical outcome changes were not significant in the year after enrollment, primary care visits did increase, and emergency department visits decreased over the year analyzed. Decreased emergency department visits and increased attendance at primary care visits suggests this model of integration allows patients access to continuity of care and primary care services.