2015 APHA Annual Meeting & Expo

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Recorded Annual Meeting Presentations (RAMP) are now available for purchase.
Only $90 for presenters, $140 for registered attendees and $200 for non-attendees.

Online Program

334902
Community-Based Integrated Care Model Demonstrates Improvements in Managing Chronic Physical and Mental Health Conditions


Wednesday, November 4, 2015 : 8:30 a.m. - 8:50 a.m.

Gerry Aguirre, LPT Admin Manager, Behavioral Health Services, Orange County Health Care Agency, Anaheim, CA
Brett O'Brien, MFT, Children, Youth, and Prevention Behavioral Health Services, Orange County Health Care Agency, Santa Ana, CA
Mary Hale, MS, Behavioral Health Services, Orange County Health Care Agency, Santa Ana, CA
Background: Can the reciprocal effects between chronic physical and mental health conditions can be managed in "integrated settings?" This presentation shares results from the Orange County Health Care Agency, which administers the Integrated Community Services (ICS) program - an effort that offers community-based integrated medical and mental health services.  

Methods: ICS enrolled 960 adults seeking mental health or medical treatment. To qualify, the person had to be diagnosed with a mental illness or self-report significant mental health symptoms.  Participants completed baseline measures of depression (PHQ-9), anxiety (GAD-7), body mass index (BMI), and blood pressure.

Findings: Mental Health: Participants who initially scored in the moderate to severe range for mental health symptoms showed a significant decrease in mood scores (baseline M=18.4, SD=5.0 vs. follow-up M=13.2, SD=7.2), t(437)=14.76, p < .001 for depression; baseline M=16.6, SD=3.5 vs. follow-up 11.6,SD=6.1, t(398)=16.37, p <.001 for anxiety).  Physical Health: There were significant drops in BMI  (baseline M=36.2, SD=6.1 vs follow-up M=35.6, SD=6.6, t(201)=2.69 p =.008); systolic blood pressure (baseline M=156.4, SD=14.3 vs follow-up M=140.1, SD=17.3, t(64)=6.44 p <.001); and diastolic blood pressure (baseline M=98.6, SD=6.4 vs follow-up M=87.3, SD=10.3, t(64)=7.36 p<.001).  Blood pressure management among hypertensive participants was compared between ICS and non-ICS participants seen at the same clinics.  More ICS participants were able to achieve blood pressure at <140/90 (i.e., 70% vs 91% respectively) as compared to non-ICS (i.e., 69% at both time points). 

Implications: These findings suggest that the standard of practice should be changed to manage chronic mental health and physical health challenges in community-based integrated settings.

Learning Areas:

Administer health education strategies, interventions and programs
Provision of health care to the public

Learning Objectives:
Evaluate mental and physical health outcomes among adults participating in an integrated, community-based health care model.

Keyword(s): Community-Based Partnership & Collaboration, Mental Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been the principal or co-principal of multiple state funded MHSA Innovations projects. Among the projects that I have developed have involved Integrated Care as well as those that involve the use of mental health peers as an integral component.
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.

Back to: 5073.0: Integrated Mental Health and Chronic Disease Intervention Strategies (organized jointly with the Mental Health section)