269451 Implementing Primary Care and Wellness in Denver's Mental Health Center

Tuesday, October 30, 2012 : 10:30 AM - 10:50 AM

Jean Demmler, PhD , Heartland Network for Social Research, Denver, CO
Rebecca Hanratty, MD , Denver Health, University of Colorado School of Medicine, Denver, CO
Susan Holligan, ANP , Mental Health Center of Denver, Integrated Primary Care and Wellness Team, Denver, CO
Christa Smith, PsyD , Touchstone Health and Wellness. LLC, Denver, CO
Mary Khoury, RN, MS , IPCW Project Manager, Mental Health Center of Denver, Denver, CO
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.

Learning Areas:
Conduct evaluation related to programs, research, and other areas of practice
Program planning
Social and behavioral sciences

Learning Objectives:
1) Describe critical elements of integrated primary and mental health services 2) Describe an example of preventative primary care within a mental health care setting 3) Identify a systems outcome that results from provision of co-located care.

Keywords: Mental Health System, Access and Services

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been the process evaluator of the IPCW project from the beginning of its implementation. In addition I have evaluated other primary care and mental health integration projects funded by local foundations in Colorado in recent years. As a sociologist, my work has focused on mental health service organizations, systems and policy research; cross-system research in the areas of human and health services; rural communities and systems of care.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.