Yale Study Finds Integrating Medical Care into Mental Health Services Overcomes Barriers to Care for the Mentally Ill

Yale investigators have found that integrating primary medical care as part of mental health services for patients with serious mental illness results in significant improvements in their health status and access to medical care.

“Patients with serious mental illness very often receive poor quality medical care and this may contribute to the higher levels of illness and mortality than are found in the rest of society,” said one of the study’s authors, Benjamin G. Druss, M.D., assistant professor in the Departments of Psychiatry and of Epidemiology and Public Health at the Yale School of Medicine. “This is the first study to examine a model for improving their medical care and health status.”

Druss and his Yale colleagues established an on-site, multi-disciplinary primary care team at an out-patient mental health clinic at the VA Connecticut Healthcare System in West Haven, Conn. The study, which appears in a recent issue of the Archives of General Psychiatry, compared the results for 120 individuals, half of whom received health care from the clinic’s primary care team while the others accessed care through a general medicine clinic at the VA.

According to the study’s findings, those individuals accessing medical care through the mental health clinic received better quality of primary care and had improved health status over time. The costs for the two groups were similar.

“It is not clear whether the poor quality of medical care patients with mental illness receive is mainly a result of patients’ fears or difficulty complying, or providers’ discomfort in treating these patients,” said Druss. “Whichever the source, the study’s findings imply that integrating primary care into the mental health clinic setting improves access and quality of medical care for these patients, as well as their health status.”

Druss and his colleagues are now examining new models to better integrate primary medical care for patients in other public-sector mental health settings.

The study was funded in part by the VA Connecticut Mental Illness Research, Education, and Clinical Center and by a grant from the National Institute of Mental Health.