Published April 29, 2014
To help meet unmet general health needs for those with serious mental illness, an interprofessional team from the University at Buffalo is bringing primary care services directly to clients of a Buffalo psychiatric facility.
Through an integrated care model, Kim Griswold, MD, MPH, associate professor of family medicine, and Diane Loomis, DNP, clinical associate professor in the School of Nursing, will provide primary care to Lake Shore Behavioral Health clients.
This marks the first integrated effort launched by UB family medicine to provide medical care for the seriously mentally ill, Griswold notes.
For those with serious mental illnesses, psychiatric treatment is often the immediate priority.
Therefore, significant primary medical needs often go untreated.
“The burden of medical illness in this population is high but, for a number of reasons, patients with behavioral health conditions may find it difficult to settle into a traditional primary care relationship,” explains Daniel J. Morelli, MD, interim chair of family medicine.
The UB providers share three main goals, notes Morelli. “They are intent on improving the health and management of chronic illness, decreasing episodic use of the health care system and improving the patient experience,” he says.
“These patients have been out of the medical system, so we’ll start with the basics,” says Griswold.
This means developing trusting relationships with patients — who all participate in Lake Shore’s Assertive Community Treatment (ACT) or Homeless Services programs — and prioritizing their health care needs, including immunizations, she explains.
Griswold says she hopes to show improved outcomes to demonstrate that primary care should be among the services ACT teams provide.
Both she and Loomis have extensive experience caring for those with serious mental illness, and have provided outreach to such patients.
The primary care facility at Lake Shore Behavioral Health also will serve as a training site for UB family medicine and nursing students.
The students will not only gain experience caring for underserved populations, they also will participate in a model for interprofessional training.
“This provides an opportunity for the students to work side by side to make a real difference in these patients’ lives,” says Griswold.
A student in the Department of Family Medicine will begin a primary care training rotation at the facility this summer.
The UB efforts will facilitate important access to primary and preventive care for a vulnerable population.
“On average, people who suffer from serious mental illness die 25 years earlier than the general population,” says Loomis.
To help improve psychiatric symptoms, patients often take psychiatric medications or smoke, but these methods “also cause terrible side effects” and can increase the risk of diabetes or lead to cardiovascular disease, Loomis notes.