Integrating Primary Care into Behavioral Health: Evaluating an Evidence-based Referral process in a Community Mental Health Facility

A collaboration to serve individuals with mental disorders and co-morbid physical health issues is vital to improving health care outcomes for the individual as a whole. Objective: This project sought to answer the following research questions: (a) Did the patients with mental illness attend referred appointments at the co-located primary health care clinic?; (b) If referred appointments at the primary health care clinic were missed, what were the most common reasons?; ( c) Did the primary care and mental health care prescribers at the colocated clinics report that the referral process was beneficial? Results: Throughout this 8 week project, there were 47 patients referred; 11 (23.4%) showed for the primary care appointment; 36 (76.6%) patients did not make it to the primary care appointments. Of the 11 who made their appointment, 10 (90%) had same day appointments, meaning the patient had both a mental health and a primary care appointment scheduled on the san1e day. Patients were asked the main reasons for missing primary care appointments; 24 (66.66%) missed due to transportation issues; 10 (27.77%) missed due to forgetfulness; 2 (5.5%) already established another primary care provider outside of Metrocare. A survey among the mental health and primary health care prescribers was done to attest to the helpfulness of the referral process. The survey was ranked on a Likert scale of 1 to 4 with 1 being not helpful to 4 being most helpful. Overall, the prescribers thought the process was helpful. Conclusions: Establishing a new referral process in an already busy mental health clinic was challenging. Overall, the clients presented with both mental health and primary health care needs, yet it appeared that maintaining scheduled primary care appointments was troublesome.