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Integrated behavioral health home improves mental health, cardiometabolic outcomes

Receiving care from an integrated behavioral health home improved outcomes among individuals with serious mental illness, according to recent findings.

“Compared with the general population, people with serious mental disorders are at risk for poor-quality medical care, and poor-quality care is likely an important determinant of adverse outcomes in this population,” Benjamin G. Druss, MD, MPH, professor of health policy and management at Emory University in Atlanta, and colleagues wrote. “One model that has attracted particular interest among providers and policy makers is the behavioral health home, a medical health home based in a community mental health center... Despite the widespread interest in and use of behavioral health homes, there are few data evaluating their impact on quality or outcomes of care.”

To compare care quality and outcomes between integrated behavioral health home and usual care, researchers conducted a randomized trial among 447 individuals with serious mental illness and at least one cardiometabolic risk factor. Study participants were randomly assigned to a behavioral health home developed between a community mental health center and a Federally Qualified Health Center or usual care for 12 months. Participants in the behavioral health home received on-site integrated medical care from a nurse practitioner and full-time nurse care manager.

Quality of cardiometabolic care, concordance of treatment with the chronic care model, and use of preventive services significantly improved among participants in the behavioral health home.

Cardiometabolic and general medical outcomes improved among both groups and there were no statistically significant differences between the two groups over time.

“The results suggest that it is possible, even under challenging, real-world conditions, to improve the quality of medical care for patients with serious mental illness and cardiovascular risk factors treated in community mental health settings. However, better quality alone may be insufficient to improve more distal medical outcomes. Addressing the poor clinical health and early mortality in this population will require multimodal strategies addressing the full range of risk factors that underlie these problems,” the researchers concluded. – by Amanda Oldt

Disclosure: The researchers report no relevant financial disclosures.