Patient Experiences With a Primary Care Medical Home Tailored for People With Serious Mental Illness

• Published in: Families systems & health 2024-06, Vol.42 (2), p.214-225
• Main Authors: Bergman, Alicia A., Chang, Evelyn T., Cohen, Amy N., Hovsepian, Sona, Oberman, Rebecca S., Vinzon, Merlyn, Young, Alexander S.
• Format: Article
• Language: English
• Subjects: Adult; Female; Health care; Human; Humans; Integrated Services; Interviews as Topic - methods; Male; Medical diagnosis; Medical Patients; Mental disorders; Mental Disorders - psychology; Mental Disorders - therapy; Mental Health; Mental health care; Middle Aged; Nursing Homes; Patient Satisfaction; Patient-Centered Care - standards; Primary care; Primary Health Care; Primary Health Care - standards; Qualitative Research; Serious Mental Illness
• ISSN: 1091-7527; 1939-0602; 1939-0602
• DOI: 10.1037/fsh0000853

Introduction: People with serious mental illness (SMI) have low rates of primary care (PC) use and die years prematurely, mostly because of medical illnesses such as cardiovascular disease or cancer. To meet the needs of these individuals, a novel, specialized patient-centered medical home with care coordination ("SMI PACT") was developed and implemented in PC. This study qualitatively examined patients' experiences with this innovative care model. Method: After implementation of the medical home in 2018, one-on-one semistructured interviews were conducted with 28 patients (32% women, 43% Black, and 25% Hispanic). Interviews were professionally transcribed and coded prior to thematic analysis. Results: Patients overwhelmingly described positive experiences with SMI PACT because of the qualities of interpersonal communication displayed by SMI PACT staff (e.g., nonjudgment, good listening, patience), structural features of the SMI PACT collaborative care model (e.g., frequent follow-up communication), and other unique aspects of the SMI PACT model tailored for SMI, such as easy-to-understand language. For these reasons, most patients expressed a desire to continue care in SMI PACT. Patients also self-reported improved engagement with their healthcare and self-management of diet, exercise, blood pressure, and diabetes control as a result of SMI PACT participation. Discussion: Patients enrolled in a specialized PC medical home identified clinician characteristics and behaviors that informed an overwhelmingly positive impression of the program model. Their experiences can guide dissemination of specialized PC models and integrated services for people with SMI. Public Significance Statement An innovative specialized primary care medical home for patients with serious mental illness was found to improve treatment quality and outcomes. Patients enrolled in this medical home have an overwhelmingly positive impression of this care model, integrated care, and identify clinician competencies that are important for effective care.