Document Detail

A learning collaborative of CMHCs and CHCs to support integration of behavioral health and general medical care.
MedLine Citation:
PMID:  21724788     Owner:  NLM     Status:  MEDLINE    
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.
Steven D Vannoy; Barbara Mauer; John Kern; Kamaljeet Girn; Charles Ingoglia; Jeannie Campbell; Laura Galbreath; Jürgen Unützer
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Psychiatric services (Washington, D.C.)     Volume:  62     ISSN:  1557-9700     ISO Abbreviation:  Psychiatr Serv     Publication Date:  2011 Jul 
Date Detail:
Created Date:  2011-07-04     Completed Date:  2011-11-23     Revised Date:  2013-03-18    
Medline Journal Info:
Nlm Unique ID:  9502838     Medline TA:  Psychiatr Serv     Country:  United States    
Other Details:
Languages:  eng     Pagination:  753-8     Citation Subset:  IM    
Department of Psychiatry and Behavioral Sciences, University of Washington, 1959 NE Pacific St., Box 356560, BB1533, Seattle, WA 98195-6560, USA.
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MeSH Terms
Chronic Disease
Community Health Centers*
Community Mental Health Services*
Cooperative Behavior*
Delivery of Health Care, Integrated / organization & administration*
Health Status Indicators
Program Development
Self Care
United States
Grant Support
Comment In:
Psychiatr Serv. 2011 Jul;62(7):701   [PMID:  21724778 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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