Implementing Primary Care and Wellness in Denver's Mental Health Center

Background: The Mental Health Center of Denver and Denver Health have implemented the Integrated Primary Care and Wellness Program (IPCW) under the auspices of the SAMHSA sponsored Primary and Behavioral Health Care Integration Grants (PBHCI). Purpose of Presentation: This program provides lessons learned regarding the implementation of primary care within a community mental health center. The presentation will report both process and system outcomes.

Methods: Project operations were observed throughout program development. Semi-structured interviews of staff and consumers provided information about what is working and where implementation adjustments are required. Health care utilization over time was assessed comparing individual consumer data prior and after their enrollment in the IPCW clinic.

Findings: Continuous steps to engage mental health case managers and to communicate across the medical and primary cultures have been critical to improve integration of services. Consumers report high satisfaction with IPCW care acknowledging they feel respected, have good care and appreciate co-located care. Utilization data indicate that once consumers are enrolled in IPCW there is a tendency to use less urgent care and more primary care. Data show a decrease of urgent care utilization of 0.36 visits per six months per consumer (p <.01) and an increase in primary care utilization (p <.01).

Conclusions: This model of integrating primary care into a mental health center is well received by consumers and is shifting health care utilization from urgent care to primary care. These findings indicate system change toward increased prevention and wellness among persons with serious mental illness.