G10 – Chronic Health Conditions and ED Utilization in a Reverse Integration Clinic

Summary

People living with Serious Mental Illness (SMI) are at significantly increased risk of chronic health conditions and negative health consequences than those without SMI. Integrated Care is not a novel concept; it is becoming increasingly common to embed behavioral health providers and services into various medical care practices (primary care, hospital units, emergency departments, pharmacies, even some big box stores. Less common, however, is “Reverse Integration”, and thinking of the behavioral health provider as the “health home”, embedding medical services and resources into behavioral health clinics. This presentation will review base rate data at a large community mental health center. We will examine the following relationships utilizing data from a depression screener (PHQ-9), Health Information Exchange (HSX), and 5 Physical Health Questions asked of all our clients: 1. Does self-report of chronic medical illness and Emergency Department (ED) usage correlate with HIE and claims data?; 2. Do clients with higher behavioral health needs (i.e., more severe depression) experience higher rates of chronic physical health conditions and/or ED utilization?; 3. Do rates of chronic physical health conditions differ by severity of depression and/or mental health diagnosis? The target population for this program is program leaders and clinicians who work with people who live with SMI, and particularly clinics interested in Reverse Integration. Too often, when we discuss integrated care, we fail to focus on the medical needs of those in Behavioral health clinics, and instead focus resources on medical clinics serving those with co-occurring SMI. It is vital that we approach integrated care from a truly holistic and bidirectional point of view, recognizing that health homes may have different points of origin.