TY - JOUR
KW - Chronic Disease
KW - Community Health Centers
KW - Community Mental Health Services
KW - Cooperative Behavior
KW - Delivery of Health Care, Integrated/organization & administration
KW - Health Status Indicators
KW - Humans
KW - Learning
KW - Program Development
KW - Questionnaires
KW - Self Care
KW - United States
AU - S. D. Vannoy
AU - B. Mauer
AU - J. Kern
AU - K. Girn
AU - C. Ingoglia
AU - J. Campbell
AU - L. Galbreath
AU - J. Unutzer
A1 - 
AB - OBJECTIVE: Integration of general medical and mental health services is a growing priority for safety-net providers. The authors describe a project that established a one-year learning collaborative focused on integration of services between community health centers (CHCs) and community mental health centers (CMHCs). Specific targets were treatment for general medical and psychiatric symptoms related to depression, bipolar disorder, alcohol use disorders, and metabolic syndrome. METHODS: This observational study used mixed methods. Quantitative measures included 15 patient-level health indicators, practice self-assessment of resources and support for chronic disease self-management, and participant satisfaction. RESULTS: Sixteen CHC-CMHC pairs were selected for the learning collaborative series. One pair dropped out because of personnel turnover. All teams increased capacity on one or more patient health indicators. CHCs scored higher than CMHCs on support for chronic disease self-management. Participation in the learning collaborative increased self-assessment scores for CHCs and CMHCs. Participant satisfaction was high. Observations by faculty indicate that quality improvement challenges included tracking patient-level outcomes, workforce issues, and cross-agency communication. CONCLUSIONS: Even though numerous systemic barriers were encountered, the findings support existing literature indicating that the learning collaborative is a viable quality improvement approach for enhancing integration of general medical and mental health services between CHCs and CMHCs. Real-world implementation of evidence-based guidelines presents challenges often absent in research. Technical resources and support, a stable workforce with adequate training, and adequate opportunities for collaborator communications are particular challenges for integrating behavioral and general medical services across CHCs and CMHCs.
BT - Psychiatric services (Washington, D.C.)
C5 - Healthcare Policy
CP - 7
CY - United States
DO - 10.1176/appi.ps.62.7.753
IS - 7
JF - Psychiatric services (Washington, D.C.)
N2 - OBJECTIVE: Integration of general medical and mental health services is a growing priority for safety-net providers. The authors describe a project that established a one-year learning collaborative focused on integration of services between community health centers (CHCs) and community mental health centers (CMHCs). Specific targets were treatment for general medical and psychiatric symptoms related to depression, bipolar disorder, alcohol use disorders, and metabolic syndrome. METHODS: This observational study used mixed methods. Quantitative measures included 15 patient-level health indicators, practice self-assessment of resources and support for chronic disease self-management, and participant satisfaction. RESULTS: Sixteen CHC-CMHC pairs were selected for the learning collaborative series. One pair dropped out because of personnel turnover. All teams increased capacity on one or more patient health indicators. CHCs scored higher than CMHCs on support for chronic disease self-management. Participation in the learning collaborative increased self-assessment scores for CHCs and CMHCs. Participant satisfaction was high. Observations by faculty indicate that quality improvement challenges included tracking patient-level outcomes, workforce issues, and cross-agency communication. CONCLUSIONS: Even though numerous systemic barriers were encountered, the findings support existing literature indicating that the learning collaborative is a viable quality improvement approach for enhancing integration of general medical and mental health services between CHCs and CMHCs. Real-world implementation of evidence-based guidelines presents challenges often absent in research. Technical resources and support, a stable workforce with adequate training, and adequate opportunities for collaborator communications are particular challenges for integrating behavioral and general medical services across CHCs and CMHCs.
PP - United States
PY - 2011
SN - 1557-9700; 1075-2730
SP - 753
EP - 758
EP - 
T1 - A learning collaborative of CMHCs and CHCs to support integration of behavioral health and general medical care
T2 - Psychiatric services (Washington, D.C.)
TI - A learning collaborative of CMHCs and CHCs to support integration of behavioral health and general medical care
U1 - Healthcare Policy
U2 - 21724788
U3 - 10.1176/appi.ps.62.7.753
VL - 62
VO - 1557-9700; 1075-2730
Y1 - 2011
ER -