Integration of primary care and mental health in a community health center: A quality improvement project to improve the health of patients with serious and persistent mental illness

Background: Severe Persistent Mental Illness (SPMI) is associated with increased morbidity compared with the general population. Our clinic serves a high percentage of SPMI patients. Purpose: A Substance Abuse and Mental Health Services Administration (SAMHSA) grant enabled our clinic to integrate medical and mental health services with the aim of decreasing morbidity in SPMI patients. Methods: This multiyear integration project included protocols for metabolic screening, increased staff to coordinate medical and mental health care, formation of an integrated treatment team, and increased patient engagement. Outcomes included biometrics and clinician feedback. Discussion: Despite significant challenges from the COVID-19 pandemic and civil unrest in our community, we saw improvements in patient biometric measurements by year 3 of the project. Conclusion: The results of this care model transformation project suggest that integration of primary and mental health care is a promising approach to decrease the burden of physical comorbidities in patients with SPMI.