UNC Center for Excellence in Community Mental Health to expand its integrated primary and behavioral care

Robin Reed, MD, MPH, assistant professor of psychiatry and director for the Center’s integrated care program, is the principal investigator for the four-year grant.

UNC Center for Excellence in Community Mental Health to expand its integrated primary and behavioral care click to enlarge Robin Reed, MD, MPH

The UNC Center for Excellence in Community Mental Health has received a $1.5 million Primary and Behavioral Health Care Integration (PBHCI) grant from the Substance Abuse and Mental Health Services Administration (SAMHSA) to enhance and fully integrate primary and behavioral (mental health) care into its patient population.

Robin Reed, MD, MPH, assistant professor of psychiatry and director for the Center’s integrated care program, is the principal investigator for the four-year grant.

Individuals who have mental illness have a high rate of chronic diseases such as cardiovascular, diabetes and hypertension die much earlier than others without the diseases. Some studies report that these untreated individuals die as much as 25 years earlier.

The integration of primary and behavioral care has been recognized at both national and state levels as a model to provide better health outcomes and quality of life for patients with severe mental illness and lower the total cost of care. Individuals with more than one illness and many with mental illness are among the mostly frequently hospitalized persons with the costliest stays.

Individuals with severe mental illness often look to their behavioral health clinician for a full range of care needs. The Center’s integrated care program monitors chronic disease and preventive care needs, enhances support during transitions between home and the hospital, improves patients’ abilities to manage their own care, increases capacity for behavioral and primary care providers to provide integrated care, and provides on-site primary care services in a behavioral health clinic as part of a Health Home model of integrating behavioral and primary care. This year the Center, in collaboration with Piedmont Health Services and UNC Family Medicine, added an on-site primary care physician to its Carr Mill clinic staff. The Center’s health home was created with funding from a 2011 grant from The Duke Endowment.

The funding will increase the number of persons with severe mental illness who receive both evidence-based behavioral treatment and primary care services. In the integrated care model, these individuals will receive preventive care services and be treated for chronic physical health conditions. Clinicians will receive specific integrated care training to help them provide a seamless transition in the delivery of behavioral and primary care.  

“We are thrilled to join the national network of the SAMHSA PBHCI programs,” says Reed.

UNC researchers expect that PBHCI participants will improve both their physical and behavioral health and, they will become more involved in their care. The clients/patients will receive improved physical health care within their community, and they will increase their health and wellness activities.

The efforts will assist local, state, and national policymakers in outlining a high-quality and cost-effective set of services that improve the experience of care for high-risk individuals who suffer from both physical and behavioral health conditions.  

“There is an enormous need to figure out how to make integrated care work, and the Center has made nice progress over the past few years,” says John Gilmore, MD, director of the Center, Thad and Alice Eure Professor, and vice chair, research and scientific affairs in the department of psychiatry at the UNC School of Medicine. “This grant will allow us to continue to develop and refine models of integrated care that can be used across North Carolina.”   

The Center, founded in 2009 with funding from The Duke Endowment, offers a continuum of care for individuals with severe mental illness at locations in Orange, Chatham and Wake counties. Additionally, the Center provides technical assistance to psychiatrists and other mental health professionals state-wide through its NC Community Medical Director’s Network and NC Assertive Community Treatment (ACT) Technical Assistance Center. 

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