Perceived Barriers to and Facilitators of Engagement in Reverse Integrated Care

Introduction: Individuals with chronic mental illness and addiction have poorer health outcomes than the general population, largely because of preventable medical conditions. Early onset and heightened incidence of chronic disease—such as type two diabetes, chronic obstructive pulmonary disease, and hypertension—might limit behavioral health consumers’ quality life years and ultimately lead to early mortality. These health risks are exacerbated by coinciding poor health correlates such as low socioeconomic status, disrupted cycles of care, and substance use. Primary and Behavioral Health Care Integration (PBHCI) initiatives address these compounding health disparities by improving access to quality primary care and wellness services inside of behavioral health centers. As opposed to traditional integrated care models in which behavioral health services are co-located in medical settings, reverse integration targets consumers with serious and persistent mental illness who are more likely to frequent behavioral health care settings. Recently, this model of reverse integrated care delivery has been on the rise because of its unique capacity to meet the complex needs of behavioral health consumers... The current study employs semi-structured individual interviews to assess behavioral health consumers’ perceived barriers to and engagement in PBHCI services at an urban community mental health center