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Open Access 08-06-2024 | Schizophrenia | Original Paper

The Impact of Structural Integration on Clinical Outcomes among Individuals with Serious Mental Illness and Chronic Illness

Authors: Elizabeth B. Matthews, Viktor Lushin, Eliza Macneal, Steve C. Marcus

Published in: Community Mental Health Journal

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Abstract

Though considered a best practice, there is substantial variation in how integrated behavioral health (IBH) services are structured. This study examined the impact of IBH structure on health outcomes among individuals with serious mental illness (SMI) and chronic disease receiving care in community health centers (CHCs). Data from the ADVANCE network identified 8,548 individuals with co-occurring SMI diabetes and 16,600 with an SMI and hypertension. Logistic regression tested whether IBH type impacted disease specific health outcomes among these populations. Among those with diabetes or hypertension, colocated care was associated with better health outcomes related to HbA1c, blood pressure control, and BMI compared to less coordinated and unintegrated care, though there was significant variation in this relationship across SMI diagnoses. Results reflect that colocation of primary care and behavioral health may improve outcomes for individuals with bipolar disorder or major depression and chronic disease, but that CHC-based integrated care may not be optimized for individuals with schizophrenia.
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Metadata
Title
The Impact of Structural Integration on Clinical Outcomes among Individuals with Serious Mental Illness and Chronic Illness
Authors
Elizabeth B. Matthews
Viktor Lushin
Eliza Macneal
Steve C. Marcus
Publication date
08-06-2024
Publisher
Springer US
Keyword
Schizophrenia
Published in
Community Mental Health Journal
Print ISSN: 0010-3853
Electronic ISSN: 1573-2789
DOI
https://doi.org/10.1007/s10597-024-01293-4