background: People living with mental illness have shortened life expectancies compared to the general population, often due to health inequity resulting from poorly managed chronic care conditions. The Behavioral Health Integration and Complex Care Initiative (BHICCI) is a large-scale system redesign that delivers integrated care to help persons living with mental illness to achieve health equity. This presentation explores BHICCI recipient perspectives about their experience of integrated care. methods: Patients from five community-based organizations participated in the present study. Focus groups were audio recorded and professionally transcribed. Transcripts were analyzed using constant comparative analysis informed by grounded theory. results: We spoke with 54 BHICCI patients in six English language focus groups and two Spanish language focus groups as part of the BHICCI's larger implementation evaluation. Three themes emerged: (1) "care coordination is crucial" - patients welcomed the support of care managers to navigate the newly designed system; (2) "awareness of implementation challenges" - patients described the experience of organizational challenges, such as hiring new medical providers to accommodate the influx of patients with complex health conditions; and (3) "integrated care has relational aspects" - patients described the importance of provider engagement with the emotional and spiritual elements of illness and recovery. conclusions: This study highlights the importance of understanding and incorporating patient experience into the design of integrated care systems. Targeted efforts are needed to ensure that health care quality improvement initiatives prioritize patient feedback and perspective.