scholarly journals A Primary Care-Public Health Partnership Addressing Homelessness, Serious Mental Illness, and Health Disparities

2013 ◽  
Vol 26 (3) ◽  
pp. 279-287 ◽  
Author(s):  
L. C. Weinstein ◽  
M. D. LaNoue ◽  
J. D. Plumb ◽  
H. King ◽  
B. Stein ◽  
...  
Keyword(s):  
Public Health ◽  
Primary Care ◽  
Mental Illness ◽  
Health Disparities ◽  
Serious Mental Illness ◽  
Health Partnership ◽  
Public Health Partnership

scholarly journals Effect of Enhanced Primary Care for People with Serious Mental Illness on Service Use and Screening

2021 ◽  
Author(s):  
Lexie R. Grove ◽  
Alex K. Gertner ◽  
Karen E. Swietek ◽  
Ching-Ching Claire Lin ◽  
Neepa Ray ◽  
...  
Keyword(s):  
Primary Care ◽  
Mental Illness ◽  
Serious Mental Illness ◽  
Service Use

scholarly journals Creating a ‘reverse’ integrated primary and mental healthcare clinic for those with serious mental illness

2015 ◽  
Vol 17 (05) ◽  
pp. 421-427 ◽  
Author(s):  
Alexandros Maragakis ◽  
Ragavan Siddharthan ◽  
Jill RachBeisel ◽  
Cassandra Snipes
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Mental Illness ◽  
Quality Of Care ◽  
Serious Mental Illness ◽  
Mental Healthcare ◽  
Policy Reforms ◽  
Mental Health Settings ◽  
Primary Care Practitioners

Individuals with serious mental illness (SMI) are more likely to experience preventable medical health issues, such as diabetes, hyperlipidemia, obesity, and cardiovascular disease, than the general population. To further compound this issue, these individuals are less likely to seek preventative medical care. These factors result in higher usage of expensive emergency care, lower quality of care, and lower life expectancy. This manuscript presents literature that examines the health disparities this population experiences, and barriers to accessing primary care. Through the identification of these barriers, we recommend that the field of family medicine work in collaboration with the field of mental health to implement ‘reverse’ integrated care (RIC) systems, and provide primary care services in the mental health settings. By embedding primary care practitioners in mental health settings, where individuals with SMI are more likely to present for treatment, this population may receive treatment for somatic care by experts. This not only would improve the quality of care received by patients, but would also remove the burden of managing complex somatic care from providers trained in mental health. The rationale for this RIC system, as well as training and policy reforms, are discussed.

scholarly journals Primary Care Reform and Service Use by People with Serious Mental Illness in Ontario

2014 ◽  
Vol 10 (1) ◽  
pp. 31-45 ◽  
Author(s):  
Leah Steele ◽  
Anna Durbin ◽  
Elizabeth Lin ◽  
J. Charles Victor ◽  
Julie Klein-Geltink ◽  
...  
Keyword(s):  
Primary Care ◽  
Mental Illness ◽  
Serious Mental Illness ◽  
Service Use ◽  
Primary Care Reform

scholarly journals Promoting Self-Care Management Among Persons With Serious Mental Illness and HIV

2011 ◽  
Vol 23 (6) ◽  
pp. 421-427 ◽  
Author(s):  
Nancy P. Hanrahan ◽  
Donna Rolin-Kenny ◽  
June Roman ◽  
Aparna Kumar ◽  
Linda Aiken ◽  
...  
Keyword(s):  
Public Health ◽  
Health Care ◽  
Mental Illness ◽  
Nursing Students ◽  
Case Studies ◽  
Serious Mental Illness ◽  
Care Management ◽  
Self Care ◽  
Public Health Nurses ◽  
Management Approach

People with a serious mental illness (SMI) along with HIV have complex health conditions. This population also has high rates of poverty, difficulty in sustaining regular housing, and limited supportive networks. Typically, the combination of psychotropic and HIV medication regimens is complicated, changes frequently, and requires coordination among multiple providers. Furthermore, fragmented and divided primary health care and mental health care systems present substantial barriers for these individuals and for the public health nurses who care for them. In this article, we present “real world” case studies of individuals with SMI and HIV and the self-care management strategies used by nurses to address medication and treatment management, build interpersonal skills, and develop sustainable health networks. The case studies can be used for quality improvement discussions among practicing public health nurses and for instructing nursing students in a self-care management approach.

scholarly journals Do care plans and annual reviews of physical health influence unplanned hospital utilisation for people with serious mental illness? Analysis of linked longitudinal primary and secondary healthcare records in England

BMJ Open ◽  
2018 ◽  
Vol 8 (11) ◽  
pp. e023135 ◽  
Author(s):  
Jemimah Ride ◽  
Panagiotis Kasteridis ◽  
Nils Gutacker ◽  
Christoph Kronenberg ◽  
Tim Doran ◽  
...  
Keyword(s):  
Primary Care ◽  
Mental Illness ◽  
Physical Health ◽  
Serious Mental Illness ◽  
Care Quality ◽  
Care Plan ◽  
Care Plans ◽  
Primary Care Quality ◽  
Hospital Utilisation ◽  
Reduced Risk

ObjectiveTo investigate whether two primary care activities that are framed as indicators of primary care quality (comprehensive care plans and annual reviews of physical health) influence unplanned utilisation of hospital services for people with serious mental illness (SMI).Design, setting, participantsRetrospective observational cohort study using linked primary care and hospital records (Hospital Episode Statistics) for 5158 patients diagnosed with SMI between April 2006 and March 2014, who attended 213 primary care practices in England that contribute to the Clinical Practice Research Datalink GOLD database.Outcomes and analysisCox survival models were used to estimate the associations between two primary care quality indicators (care plans and annual reviews of physical health) and the hazards of three types of unplanned hospital utilisation: presentation to accident and emergency departments (A&E), admission for SMI and admission for ambulatory care sensitive conditions (ACSC).ResultsRisk of A&E presentation was 13% lower (HR 0.87, 95% CI 0.77 to 0.98) and risk of admission to hospital for ACSC was 23% lower (HR 0.77, 95% CI 0.60 to 0.99) for patients with a care plan documented in the previous year compared with those without a care plan. Risk of A&E presentation was 19% lower for those who had a care plan documented earlier but not updated in the previous year (HR: 0.81, 95% CI 0.67 to 0.97) compared with those without a care plan. Risks of hospital admission for SMI were not associated with care plans, and none of the outcomes were associated with annual reviews.ConclusionsCare plans documented in primary care for people with SMI are associated with reduced risk of A&E attendance and reduced risk of unplanned admission to hospital for physical health problems, but not with risk of admission for mental health problems. Annual reviews of physical health are not associated with risk of unplanned hospital utilisation.

Variations in Disaster Preparedness by Mental Health, Perceived General Health, and Disability Status

2009 ◽  
Vol 3 (1) ◽  
pp. 33-41 ◽  
Author(s):  
David P. Eisenman ◽  
Qiong Zhou ◽  
Michael Ong ◽  
Steven Asch ◽  
Deborah Glik ◽  
...  
Keyword(s):  
Public Health ◽  
Mental Health ◽  
Mental Illness ◽  
Serious Mental Illness ◽  
Disaster Preparedness ◽  
General Health ◽  
Emergency Plan ◽  
Communication Plan ◽  
Disability Status ◽  
Fair Poor

ABSTRACTObjectives: Chronic medical and mental illness and disability increase vulnerability to disasters. National efforts have focused on preparing people with disabilities, and studies find them to be increasingly prepared, but less is known about people with chronic mental and medical illnesses. We examined the relation between health status (mental health, perceived general health, and disability) and disaster preparedness (home disaster supplies and family communication plan).Methods: A random-digit-dial telephone survey of the Los Angeles County population was conducted October 2004 to January 2005 in 6 languages. Separate multivariate regressions modeled determinants of disaster preparedness, adjusting for sociodemographic covariates then sociodemographic variables and health status variables.Results: Only 40.7% of people who rated their health as fair/poor have disaster supplies compared with 53.1% of those who rate their health as excellent (P < 0.001). Only 34.8% of people who rated their health as fair/poor have an emergency plan compared with 44.8% of those who rate their health as excellent (P < 0.01). Only 29.5% of people who have a serious mental illness have disaster supplies compared with 49.2% of those who do not have a serious mental illness (P < 0.001). People with fair/poor health remained less likely to have disaster supplies (adjusted odds ratio [AOR] 0.69, 95% confidence interval [CI] 0.50–0.96) and less likely to have an emergency plan (AOR 0.68, 95% CI 0.51–0.92) compared with those who rate their health as excellent, after adjusting for the sociodemographic covariates. People with serious mental illness remained less likely to have disaster supplies after adjusting for the sociodemographic covariates (AOR 0.67, 95% CI 0.48–0.93). Disability status was not associated with lower rates of disaster supplies or emergency communication plans in bivariate or multivariate analyses. Finally, adjusting for the sociodemographic and other health variables, people with fair/poor health remained less likely to have an emergency plan (AOR 0.66, 95% CI 0.48–0.92) and people with serious mental illness remained less likely to have disaster supplies (AOR 0.67, 95% CI 0.47–0.95).Conclusions: People who report fair/poor general health and probable serious mental illness are less likely to report household disaster preparedness and an emergency communication plan. Our results could add to our understanding of why people with preexisting health problems suffer disproportionately from disasters. Public health may consider collaborating with community partners and health services providers to improve preparedness among people with chronic illness and people who are mentally ill. (Disaster Med Public Health Preparedness. 2009;3:33–41)

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