Promoting the Integration of Primary Behavioral Health Care - Project Abstract Name: Promoting the Integration of Primary Behavioral Health Care The Indiana Department of Health (IDOH) proposes to serve 1,000 people annually and 5,000 individuals for the life of the program including 1) adults with a serious mental illness (SMI); 2) adults who have co-occurring mental illness and physical health conditions or chronic disease; 3) children and adolescents with a serious emotional disturbance (SED) who have a co-occurring physical health conditions or chronic disease, and 4) individuals with a substance use disorder (SUD) through three Federally Qualified Health Centers (FQHCs). Partners include Community HealthNet (CHN), HealthLinc, and Valley Professionals Community Health Center (VPCHC). CHN will implement the program in 4 clinics in Lake County. HealthLinc will implement the program in each of its 16 locations in Starke, St. Joseph, Porter, LaPorte, and Lake counties. VPCHC will implement the program in 10 clinics in Parke, Vermillion, and Vigo counties. The FQHCs serve both metropolitan and rural communities. Most of Indiana’s mental health patients find care at the community level as reflected in the Indiana 2020 Mental Health National Outcomes Measures: SAMHSA Uniform Reporting System, stating there were 137,963 Seriously Mentally Ill (SMI) adults and Children with Serious Emotional Disturbance (SED) served by community healthcare providers rather than in state hospitals. About 28.7% of the adults and 2.5% of children were seen in community settings who received services for co-occurring mental illness and substance abuse. This supports a strategy to expand community based mental health care in facilities like FQHCs that already exist and can provide health services integratedly. Indiana’s Behavioral Health Commission’s 2023 report states, “Primary care providers play a critical role in the overall health and well-being of individuals: Their role as first contact providers of comprehensive and continuous care makes them well-suited to treat any mental illness; they are well-trained to address mental health needs and currently provide the largest proportion of mental health care in the United States; primary care is accessible to all patients regardless of geography or ability to pay; in contrast with mental health specialists who practice mostly in urban areas, primary care physicians practice in urban and rural areas, and are more likely to take all types of insurance; primary care professionals are the major providers of care in safety-net settings and see patients of all ages, making them the first contact for patients in all demographics with mental illness.” Mental Health America’s 2022 report The State of Mental Health in America, underscores the need for increased community level access with the finding that Indiana ranks 43rd in the nation according to the prevalence of mental illness with access to care. States that are ranked 39-51 indicate that adults have higher prevalence of mental illness and lower rates of access to care. Indiana ranks 26th regarding youth prevalence and access. As access expands, an additional goal with this proposal is to provide services that will enable FQHCs to become Certified Community Behavioral Health Centers.
