title: Health Care Decisions among Mental Health Services Consumers in San Diego County: Implications for Integrated Care.
abstract: People living with serious mental illness are at elevated risk for chronic diseases compared with those in the general population. Whether integrated care for this population would be most accessible in primary care or mental health settings is unclear. The cross-sectional study described in this article used descriptive analyses and multinomial logistic regression to assess factors associated with using physical health services from primary or mental health providers. Data were drawn from a large-scale assessment of client-reported use of primary care services in a large and ethnically diverse public mental health system. Most people (80.4 percent) reported accessing primary care services from one or more service settings. Having chronic conditions was associated with accessing physical health care from multiple service settings, whereas having poor self-rated emotional health decreased health services use from any setting. It was concluded that mental health services consumers access health care from various service settings. Social workers can play a critical role in enhancing care coordination across the mental health and primary care systems.
authors.affiliation: Department of Family Medicine and Public Health, University of California, San Diego, USA.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Siantz
authors.affiliation: School of Social Work, University of Southern California, Los Angeles, USA.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Henwood
authors.affiliation: Health Services Research Center, University of California, San Diego, USA.
authors.forename: Zhun
authors.initials: Z
authors.lastname: Xu
authors.affiliation: Health Services Research Center, University of California, San Diego, USA.
authors.forename: Andrew
authors.initials: A
authors.lastname: Sarkin
authors.affiliation: Division of Health Policy, Department of Family Medicine and Public Health, University of California, San Diego, USA.
authors.forename: Todd
authors.initials: T
authors.lastname: Gilmer
mesh_terms: D003266:Continuity of Patient Care; D003430:Cross-Sectional Studies; D006297:Health Services Accessibility; D006801:Humans; D001523:Mental Disorders / Q000150:complications*; D008605:Mental Health Services; D011320:Primary Health Care
keywords: care management; chronic diseases; mental health services; primary care