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An Examination of New York State’s Integrated Primary and Mental Health Care Services for Adults with Serious Mental Illness

An Examination of New York State’s Integrated Primary and Mental Health Care Services for Adults with Serious Mental Illness

Deborah M. Scharf
Joshua Breslau
Nicole Schmidt Hackbarth
Daniela Kusuke
B. Lynette Staplefoote
Harold Alan Pincus
Copyright Date: 2014
Published by: RAND Corporation
Pages: 173
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  • Book Info
    An Examination of New York State’s Integrated Primary and Mental Health Care Services for Adults with Serious Mental Illness
    Book Description:

    Several ongoing New York state initiatives promote integrated care for adults with serious mental illness, provided or coordinated by community mental health center staff. This report examines Primary and Behavioral Health Care Integration grants, Medicaid Incentives, and Medicaid Health Homes and concludes with recommendations for strengthening state integrated care initiatives.

    eISBN: 978-0-8330-8974-8
    Subjects: History, Health Sciences, Public Health

Table of Contents

  1. Front Matter
    (pp. i-ii)
  2. Preface
    (pp. iii-iv)
  3. Abstract
    (pp. v-v)
  4. Table of Contents
    (pp. vi-viii)
  5. Figures
    (pp. ix-ix)
  6. Tables
    (pp. x-x)
  7. Executive Summary
    (pp. xi-xxvi)

    This report describes the RAND Corporation’s examination of approaches to integrated care implemented by New York state community mental health centers for adults with serious mental illness. The purpose of the project was to generate information that will help state policymakers streamline the adoption of promising approaches to improving the overall wellness and physical health of people with serious mental illness by making primary medical services available in or coordinated by staff in the mental health settings where this population already receives care. To do this, we characterized, compared, and contrasted three integrated care initiatives operating in the state. From...

  8. Acknowledgments
    (pp. xxvii-xxvii)
  9. Abbreviations
    (pp. xxviii-xxix)
  10. Chapter One. Introduction
    (pp. 1-14)

    This report describes the RAND Corporation’s examination of New York state (NYS)’s mental health (MH)-based models of integrated primary and mental health care services for adults with serious mental illness (SMI). The purpose of this research is to characterize, compare, and contrast emerging integrated care initiatives provided by or coordinated by mental health clinics operating in NYS. Ideally, this information will enable policymakers to streamline and improve programs offering MH-based physical health (PH) care services to their SMI clientele. At the time of this research, there were three ongoing, integrated care initiatives of this type operating in NYS, targeting adults...

  11. Chapter Two. Site Visits
    (pp. 15-33)

    To observe how the policy efforts described in Chapter One are working across the state, we conducted a series of site visits to MH clinics and HH agencies. Sites were selected from across urban and rural areas of the state with a focus on selecting sites where leadership has taken an active role in developing or advancing PC services for the adults with SMI whom they treat. The goal of the site visits was to describe and compare the experiences of clinics that are pushing the envelope of primary care integration, focusing on factors that, according to the people implementing...

  12. Chapter Three. Surveys
    (pp. 34-58)

    In this chapter, we describe the experience of NYS’s MH clinics providing integrated care to adults with SMI with data from two separate but complementary surveys: (1) a clinic-level survey, completed cooperatively by one or more clinic administrative staff, describing the characteristics of the clinic’s integrated MH and PC services; (2) a provider-level survey, completed by individual PC, MH, and CM/CC providers, detailing their experiences delivering integrated care in relation to the MH clinic. Respondents to the provider-level survey were selected from within the clinics that participated in the clinic-level survey.

    Both surveys covered similar topics, including clinic structure, range...

  13. Chapter Four. Summary and Recommendations
    (pp. 59-76)

    Throughout this report, we describe NYS’s MH clinics’ experiences providing or coordinating integrated PC for adults with SMI. As noted throughout the report, our research has some limitations, including small sample sizes and limitations of the representativeness of the sample, the qualitative nature of the research, and the omission (though a strategic decision) of the experiences of clinics not providing integrated care. Nonetheless, this report makes a number of contributions to the current research and policy literature. First, we describe the experience of SAMHSA’s federal PBHCI grant program, with multiple, diverse sites operating in a single policy environment. This information...

  14. References
    (pp. 77-81)
  15. Appendix A: Standard Framework for Levels of Integrated Health Care
    (pp. 82-83)
  16. Appendix B: Brief Summary of Forthcoming Federal and State Initiatives Impacting Integrated Care
    (pp. 84-85)
  17. Appendix C: Distribution of Program Survey Respondents
    (pp. 86-86)
  18. Appendix D: New York State Integrated Physical and Behavioral Health Care Provider Survey
    (pp. 87-87)
  19. Appendix E: New York State Integrated Physical and Behavioral Health Care Program Survey
    (pp. 88-88)