TY - JOUR
AU - M. F. Brunette
AU - G. L. Sowden
AU - P. Martinez-Camblor
AU - A. C. Erickson
AU - J. G. Bourassa
AU - T. E. Burdick
AU - A. H. Chalsma
AU - J. C. Ferron
AU - S. E. Lord
AU - S. I. Pratt
AU - J. A. Sagona
A1 - 
AB - OBJECTIVE: People with serious mental illness (i.e., disabling psychotic, mood, and other disorders) develop chronic medical diseases early in life. This study aimed to examine the effects of integrating primary care into community mental health centers (CMHCs; reverse integrated care) on service use among young adults with serious mental illness who may benefit from early intervention. METHODS: This retrospective cohort analysis used Medicaid claims of 945 people with serious mental illness (ages 18-40) in CMHC care from 2020 to 2022-315 in reverse integrated care and 630 propensity score matched participants in comparison care (i.e., not reverse integrated care). Logistic regression, adjusted for participant characteristics, enrollment quarter, and past service use, assessed outcomes in the 6 months after enrollment. RESULTS: Participants' mean±SD age was 32.56 ± 7.84 years; 29% had a diagnosis of schizophrenia, 40% had a co-occurring substance use disorder, 33% had a medical emergency department (ED) visit in the 6 months before enrollment, and all were enrolled in CMHC care at baseline. During follow-up, participants in reverse integrated care were more likely to have an outpatient medical visit (65% vs. 58%; adjusted odds ratio [AOR]=1.54, p=0.005) and were less likely to have a medical ED visit (26% vs. 33%; AOR=0.70, p=0.035) than those in comparison care. CONCLUSIONS: Integrating primary care into CMHC services may increase access to outpatient medical care and reduce ED visits for medical reasons among young adults with serious mental illness. Future research should confirm these findings, assess longer-term outcomes, and examine implementation facilitators and barriers.
AD - Department of Psychiatry, Dartmouth Health and Geisel School of Medicine, Dartmouth College, Hanover, NH.; New Hampshire Department of Health and Human Services, Concord.; Department of Biomedical Data Science, Geisel School of Medicine, Dartmouth College, Hanover, NH.; Department of Anesthesiology, Dartmouth Health and Geisel School of Medicine, Hanover, NH.; The Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, NH.; Department of Community and Family Medicine, Dartmouth Health and Geisel School of Medicine, Hanover, NH.
AN - 41174946
BT - Psychiatr Serv
C5 - Healthcare Disparities
CP - 11
DA - Nov 1
DO - 10.1176/appi.ps.20250042
DP - NLM
IS - 11
JF - Psychiatr Serv
LA - eng
N2 - OBJECTIVE: People with serious mental illness (i.e., disabling psychotic, mood, and other disorders) develop chronic medical diseases early in life. This study aimed to examine the effects of integrating primary care into community mental health centers (CMHCs; reverse integrated care) on service use among young adults with serious mental illness who may benefit from early intervention. METHODS: This retrospective cohort analysis used Medicaid claims of 945 people with serious mental illness (ages 18-40) in CMHC care from 2020 to 2022-315 in reverse integrated care and 630 propensity score matched participants in comparison care (i.e., not reverse integrated care). Logistic regression, adjusted for participant characteristics, enrollment quarter, and past service use, assessed outcomes in the 6 months after enrollment. RESULTS: Participants' mean±SD age was 32.56 ± 7.84 years; 29% had a diagnosis of schizophrenia, 40% had a co-occurring substance use disorder, 33% had a medical emergency department (ED) visit in the 6 months before enrollment, and all were enrolled in CMHC care at baseline. During follow-up, participants in reverse integrated care were more likely to have an outpatient medical visit (65% vs. 58%; adjusted odds ratio [AOR]=1.54, p=0.005) and were less likely to have a medical ED visit (26% vs. 33%; AOR=0.70, p=0.035) than those in comparison care. CONCLUSIONS: Integrating primary care into CMHC services may increase access to outpatient medical care and reduce ED visits for medical reasons among young adults with serious mental illness. Future research should confirm these findings, assess longer-term outcomes, and examine implementation facilitators and barriers.
PY - 2025
SN - 1075-2730
SP - 988
EP - 996+
ST - Impact of Community Mental Health-Based Integrated Care on Service Use Among Young Adults With Serious Mental Illness
T1 - Impact of Community Mental Health-Based Integrated Care on Service Use Among Young Adults With Serious Mental Illness
T2 - Psychiatr Serv
TI - Impact of Community Mental Health-Based Integrated Care on Service Use Among Young Adults With Serious Mental Illness
U1 - Healthcare Disparities
U3 - 10.1176/appi.ps.20250042
VL - 76
VO - 1075-2730
Y1 - 2025
ER -