Kathleen Mary McDermott
2015 Zenodo  
Historically, treatment for serious mental illness (SMI) has been separated from the rest of medicine resulting in gaps in medical care, redundant care, and increased costs. To address the healthcare needs of those with SMI, primary care services are now being embedded in and connected to community mental health centers (CMHCs). The purpose of this project was to describe and analyze the system changes that occurred in a nationally recognized CMHC's grant-funded initiatives to integrate primary
more » ... and behavioral healthcare into its repertoire of services for persons with SMI. Grant outcomes included increasing the number of persons with SMI who were connected with a primary care provider (PCP) in the local community and those who have active insurance. These outcomes were successful, as nearly three-quarters of the previously uninsured members became connected with public insurance, and 122 members were connected with a community PCP. Other deliverables designed to increase the level of integration at the CMHC encountered barriers, such as staff resistance, EHR challenges, philosophical differences, and the need for program re-design and highlighted the lack of coordination between agencies. This case study suggests that efforts to provide integrated care in a CMHC may necessitate an organizational culture shift that includes the active, cohesive, and clear support of leadership. In addition, strong theoretical underpinnings are necessary to support the change. Prochaska and DiClemente's stages of change (1982) and Roger's Diffusion of Innovations (1962) are examples of theories that can help organizations to successfully adapt to a fully integrated care system.
doi:10.5281/zenodo.4429978 fatcat:4c5ic2n7mrgtxeqzups2iwb7i4