Americans with severe and persistent mental illness are twice as likely as the general population to develop diabetes, high cholesterol, hypertension and morbid obesity. More than half are smokers, compared to just one quarter of the general population. Overall, the mentally ill die an average of 25 years earlier than the general population.
In an effort to address those bleak statistics, UMMS researchers will focus on getting patients with mental illness the primary care they need to improve their overall health status.
“Contributing factors such as lack of access to primary care, high rates of tobacco use, poor nutrition, homelessness or unstable housing, and limited options for physical activity are well known, but until now, there has been little exploration of systemic interventions that can make a difference for this very high risk group,” said Marie Hobart, MD, chief medical officer for Community Healthlink, Inc. (CHL) and assistant professor of psychiatry. “Our proposal for primary and behavioral health care integration attempts to address this disparity.”
Along with CHL staff psychiatrist Sarah Langenfeld, MD, also an assistant professor of psychiatry, Dr. Hobart is co-principal investigator of a $1.9 million, four-year grant from the federal Substance Abuse and Mental Health Services Administration (SAMHSA) designed to bridge the gap between primary and mental health care for individuals such as those served by CHL.
Since 1977, CHL, an affiliate of UMass Memorial Health Care and a practice and teaching site for UMass Medical School faculty, has been helping Central Massachusetts adults, children and families to recover from the effects of mental illness, substance abuse and homelessness.
The grant provides funding for The Family Health Center of Worcester to provide a primary care nurse practitioner to be housed at CHL, with immediate access to backup support from the primary care physician staff at the clinic, which is right across the street from CHL’s Worcester facility. In addition, two nurse care managers at CHL will assess and coordinate patients’ primary care needs, tracking and following their health care appointments, laboratory tests and treatments, and maintaining communication between the patient and primary care and mental health providers. The nurse care managers will also provide education and support, both individually and in groups, regarding nutrition, physical activity, smoking cessation and stress management in collaboration with peer support workers and clinicians.
Whether the grant-funded intervention proves to be successful for the approximately 400 CHL patients who will be followed over a four-year period will be based on the improvement in specific health measures such as cholesterol, blood sugar, weight and blood pressure. “Our patients have the same health care needs as everyone, they just have different barriers and challenges to meeting them,” Hobart explained. “Coordinating and providing primary care onsite will greatly increase the likelihood that our patients will receive sustained, continuous care.”