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. 2022 Aug 1;73(8):942-945.
doi: 10.1176/appi.ps.202100177. Epub 2022 Feb 9.

Lessons Learned From a New Reverse-Integration Model to Improve Primary Care Screening in Community Mental Health Settings

Christina Mangurian  1 , Marilyn D Thomas  1 , Fumi Mitsuishi  1 , L Elizabeth Goldman  1 , Grace Niu  1 , Margaret A Handley  1 , Nicholas S Riano  1 , Alison Hwong  1 , Susan Essock  1 , James Dilley  1 , John W Newcomer  1 , Dean Schillinger  1
Affiliations

Lessons Learned From a New Reverse-Integration Model to Improve Primary Care Screening in Community Mental Health Settings

Christina Mangurian et al. Psychiatr Serv. .

Abstract

The authors sought to describe a reverse-integration intervention aimed at improving preventive health screening in a community mental health clinic. The intervention, CRANIUM (cardiometabolic risk assessment and treatment through a novel integration model for underserved populations with mental illness), integrated primary care services into a large urban community mental health setting. It was implemented in 2015 and included a patient-centered team, population-based care, emphasis on screening, and evidence-based treatment. CRANIUM's strengths included provider acceptability, a patient-centered approach, sustained patient engagement, and economic feasibility. Challenges included underutilized staff, registry maintenance, and unanticipated screening barriers. The CRANIUM reverse-integration model can be feasibly implemented and was acceptable to providers.

Keywords: Care integration; Community mental health centers; Community mental health services; Diabetes; Program evaluation; Schizophrenia.

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Conflict of interest statement

Dr. Niu received consulting fees from the Advancing Integrated Mental Health Solutions Center, University of Washington. In the past 3 years, Dr. Newcomer has served as a consultant to Intra-Cellular Therapies, Sunovion, Otsuka, and Alkermes; he has been a consultant to patent litigation on behalf of Sunovion; and he serves on a data safety monitoring board for Amgen. The other authors report no financial relationships with commercial interests.

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