title: Contours of usual care: meeting the medical needs of diverse people with serious mental illness.
abstract: OBJECTIVE
  To examine practices, barriers, and recommendations for addressing the physical health of racially and ethnically diverse people with serious mental illness (SMI).
  
  
  METHODS
  Semi-structured interviews and participant observations were conducted with 21 administrators and 25 clinicians representing six mental health care organizations. Data were analyzed using constant comparative methods.
  
  
  RESULTS
  Practices included intermittently collecting consumers' physical health data, connecting consumers with primary care, and providing on-site, culturally-tailored health promotion programs. Barriers included limited care coordination infrastructure, financial and professional boundaries, unhealthy local environments and culturally-specific dietary habits. Recommendations included: strengthening dialogue with medical providers and developing staff training programs.
  
  
  CONCLUSIONS
  Meeting the physical health needs of diverse consumers with SMI is impeded by organizational, environmental, and consumer-level barriers. Establishing better care coordination networks, increasing mental health provider education on medical issues, and culturally-tailoring health promotion programming provide plausible strategies for improving the physical health of this vulnerable population.
authors.forename: Jerel M
authors.initials: JM
authors.lastname: Ezell
authors.forename: Leopoldo J
authors.initials: LJ
authors.lastname: Cabassa
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Siantz
mesh_terms: D003466:Cultural Characteristics; D005260:Female; D006293:Health Promotion; D006297:Health Services Accessibility; D006301:Health Services Needs and Demand; D054625:Healthcare Disparities; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D001523:Mental Disorders / Q000150:complications*; D008605:Mental Health Services / Q000458:organization & administration*; D008875:Middle Aged; D009519:New York City; D011320:Primary Health Care; D012931:Social Environment