Adults with serious mental illnesses are at high risk of developing chronic diseases, resulting in shortened lifespans. Patient self-directed and provider-supported approaches significantly increase patient activation in care, engagement in primary and specialty care, and perceived mental health status among patients with serious mental health issues, according to new research.
The University of Pittsburgh Medical Center (UPMC) for High-Value Health Care found that patient self-directed and provider-supported approaches significantly increase patient activation in care, engagement in primary and specialty care, and perceived mental health status among patients with serious mental health issues, according to a study published in Health Affairs.
A comprehensive behavioral health home plus model was designed by the Community Care Behavioral Health Organization for patients with serious mental illnesses who are at high risk for developing chronic diseases, resulting in shortened lifespans.
"Adults with serious mental illness have a decreased life expectancy of up to 25 years compared to the general population and are often faced with a combination of high medical needs and challenges in accessing high quality medical care," James Schuster, MD, MBA, chief medical officer for Medicaid, special needs, and behavioral services at UPMC Insurance Services Division and lead author of the Health Affairs study, said in a press release. "Often, these individuals are at high risk for chronic disease, which makes the integration of behavioral health and physical health critically important."
Funded through an award from the Patient-Centered Outcomes Research Institute (PCORI), the study included 11 community mental health providers located in Pennsylvania who delivered 1 of 2 behavioral health home approaches, patient self-directed or provider-supported. These providers were supported through a culture of wellness promoting healthy lifestyles, disease prevention, and health education.
The results of the study showed that a learning collaborative process used to support the model implementation assisted both patients and providers to improve health and wellness.
"The results of this important study can positively impact the way physical and behavioral health care services are delivered to patients with serious mental illness in Pennsylvania and beyond," stated David Kelley, MD, MBA, chief medical officer at the Pennsylvania Department of Human Services' Office of Medical Assistance Programs. "This model demonstrates the value of Pennsylvania's approach to behavioral health services for Medicaid members, which encourages close collaboration between patients, providers, county-based human service programs, and managed care organizations."
Since the success of the behavioral health home approaches in the study, over 40 additional providers in the state of Pennsylvania have implemented similar models. PCORI has awarded another grant to the UPMC Center for High-Value Health Care to create a behavioral health home plus model for adults in methadone treatment programs and children in residential treatment programs.
"This integrated model for individuals with serious mental illness is both valuable and innovative," added Allison Hamblin, senior vice president at Center for Health Care Strategies. "We have been working with the UPMC Center for High-Value Health Care and Community Care Behavioral Health Organization for over a decade to enhance this and similar programs and appreciate this clear demonstration of program efficacy. Many elements of this model are worthy of broad replication across the country."
Schuster J, Nikolajski, Kogan J, et al. A payer-guided approach to widespread diffusion of behavioral health homes in real-world settings. Health Aff. 2018;37(2). Published online February 5, 2018. Accessed February 19, 2018. https://doi.org/10.1377/hlthaff.2017.1115