TY - JOUR
AU - E. B. Matthews
AU - V. Lushin
AU - E. Macneal
AU - S. C. Marcus
A1 - 
AB - 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.
AD - Graduate School of Social Service, Fordham University, 113 W. 60th St, New York, NY, 10023, USA. ematthews13@fordham.edu.; National Institutes of Mental Health, 6001 Executive Boulevard, MSC 9663, Bethesda, MD, 20892-9663, USA.; Center for Mental Health, University of Pennsylvania, 3535 Market St, Philadelphia, PA, 19104, USA.
AN - 38850504
BT - Community Ment Health J
C5 - Healthcare Disparities
CP - 7
DA - Oct
DO - 10.1007/s10597-024-01293-4
DP - NLM
ET - 20240608
IS - 7
JF - Community Ment Health J
LA - eng
N2 - 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.
PY - 2024
SN - 0010-3853 (Print); 0010-3853
SP - 1372
EP - 1379+
ST - The Impact of Structural Integration on Clinical Outcomes among Individuals with Serious Mental Illness and Chronic Illness
T1 - The Impact of Structural Integration on Clinical Outcomes among Individuals with Serious Mental Illness and Chronic Illness
T2 - Community Ment Health J
TI - The Impact of Structural Integration on Clinical Outcomes among Individuals with Serious Mental Illness and Chronic Illness
U1 - Healthcare Disparities
U3 - 10.1007/s10597-024-01293-4
VL - 60
VO - 0010-3853 (Print); 0010-3853
Y1 - 2024
ER -