Table 1
Attributes of Patients Who Participated in Focus Groups (N = 75 across 9 sites).
| Characteristic | N | (%) |
|---|---|---|
| Age (N = 74),years, mean ± SD | 49 ± 9 | |
| Male | 42 | 56 |
| Female | 33 | 44 |
| Race/ethnicity (N = 75) | ||
| White | 34 | 45 |
| Black | 15 | 20 |
| Hispanic | 29 | 39 |
| Other | 3 | 4 |
| Education (N = 75) | ||
| No general education development (GED)/equivalent | 11 | 15 |
| GED or high school diploma | 38 | 51 |
| Some college | 22 | 29 |
| College degree or higher | 4 | 5 |
| Mental health diagnoses (N = 75) | ||
| Bipolar | 28 | 37 |
| Schizophrenia | 18 | 24 |
| Depression | 58 | 77 |
| Other | 24 | 32 |
| Primary care diagnoses (N = 75) | ||
| Hypertension | 46 | 61 |
| Diabetes | 29 | 39 |
| COPD (chronic obstructive pulmonary disease) | 15 | 20 |
| Asthma | 9 | 12 |
| Other | 27 | 36 |
| Insurance status (N = 74) | ||
| Uninsured | 46 | 61 |
| Insured | ||
| Medicaid | 12 | 16 |
| Medicare | 5 | 7 |
| Dual eligible (Medicaid + Medicare) | 7 | 9 |
| Other insured | 5 | 7 |
| Income (N = 71) | ||
| 0–$14,999 | 69 | 97 |
| $15,000–$34,999 | 2 | 3 |
| Living situation | ||
| Live alone (N = 74) | 26 | 35 |
| Homeless within last year (N = 72) | 31 | 41 |
| Reported reliable access to transportation (N = 73) | 54 | 74 |
[i] Numbers may >100% because participants could select multiple responses to the question or because of rounding.
Table 2
Attributes of Integration across Community Mental Health Centers (N = 10).
| CMHC only (N = 4) | CMHC + FQHC (N = 4) | CMHC + other PC (N = 2) | Overall (N = 10) | |||||
|---|---|---|---|---|---|---|---|---|
| Integration attributes | N | % | N | % | N | % | N | % |
| Physical facilities | ||||||||
| Remodeled existing clinic space | 4 | 100 | 4 | 100 | 2 | 100 | 10 | 100 |
| Had usual PC physical exam rooms | 4 | 100 | 4 | 100 | 2 | 100 | 10 | 100 |
| PC and MH on same floor of same building | 2 | 50 | 3 | 75 | 2 | 100 | 7 | 70 |
| On-site pharmacy | 2 | 50 | 0 | 0 | 0 | 0 | 2 | 20 |
| On-site lab sample collection | 3 | 75 | 4 | 100 | 1 | 50 | 8 | 80 |
| On-site dental practice | 0 | 0 | 1 | 25 | 0 | 0 | 1 | 10 |
| Scope of practice | ||||||||
| Health education | ||||||||
| Nutrition | 4 | 100 | 3 | 75 | 1 | 50 | 8 | 80 |
| Exercise | 4 | 100 | 3 | 75 | 0 | 0 | 7 | 70 |
| Used a specific exercise coaching model | 0 | 0 | 1 | 25 | 0 | 0 | 1 | 10 |
| Smoking cessation coaching | 4 | 100 | 3 | 75 | 2 | 100 | 9 | 90 |
| Used specific smoking cessation model | 2 | 50 | 2 | 50 | 1 | 50 | 5 | 50 |
| Tangible rewards for progress | 1 | 25 | 1 | 25 | 1 | 50 | 3 | 30 |
| Staff recruitment and retention | ||||||||
| PCP employed by CMHC | 4 | 100 | 1 | 25 | 1 | 50 | 6 | 60 |
| Loss of PCP delayed/paused primary care | 2 | 50 | 1 | 25 | 1 | 50 | 4 | 40 |
| Other primary care turnover in first year | 1 | 25 | 1 | 25 | 0 | 0 | 2 | 20 |
| CMHC/partner staff members providing integrated care, mean ± SD, range | ||||||||
| # FTEs in first year of operations | 7 ± 2 | 4–9 | 12 ± 9 | 4–27 | 6 ± 3 | 4–9 | 9 ± 6 | 4–27 |
| # FTEs in second year of operations | 14 ± 13 | 4–37 | 13 ± 8 | 7–26 | 7 ± 3 | 3–10 | 12 ± 10 | 3–37 |
| % growth in integrated team size between 1st and 2nd interview (1 year apart) | 106 | 6 | 11 | 39 | ||||
| % FTEs departed between 1st and 2nd interview | 36 | 37 | 57 | 41 | ||||
| Patient engagement | ||||||||
| Warm hand-offs (MHC → PC) | 2 | 50 | 4 | 100 | 2 | 100 | 8 | 80 |
| Walk-in physical care available | 3 | 75 | 4 | 100 | 2 | 100 | 9 | 90 |
| Total # patients in first year of operations | 2,717 | 2,934 | 157 | 5,808 | ||||
| Total # patients in second year of operations, % increase from first year | 3,747 | 38 | 6,101 | 108 | 793 | 405 | 10,641 | 83 |
| Information sharing | ||||||||
| Electronic health records | 4 | 100 | 1 | 25 | 2 | 100 | 7 | 70 |
| Common health records | 4 | 100 | 3 | 75 | 1 | 50 | 8 | 80 |
| Behavioral health care liaison or care coordinator | 3 | 75 | 4 | 100 | 2 | 100 | 9 | 90 |
| Review performance data | 1 | 25 | 3 | 75 | 0 | 0 | 4 | 40 |
| Use clinical pathways | 1 | 25 | 1 | 25 | 0 | 0 | 2 | 20 |
[i] Abbreviations: CMHC, community mental health center; FQHC, Federally Qualified Health Center; MHC, mental health care provider; PC, primary care; PCP, primary care professional.