Can primary care serve as a mental health home for people with schizophrenia?

• Published in: General hospital psychiatry
• Main Authors: Grove, Lexie R, Olesiuk, William J, Ellis, Alan R, Lichstein, Jesse C, DuBard, Annette, Farley, Joel F, Jackson, Carlos, Beadles, Christopher A, Morrissey, Joseph P, Domino, Marisa Elena
• Format: Journal Article
• Language: English
• Published: 2017
• Subjects: Psychiatry; Medical homes; Schizophrenia; Comorbid conditions; Primary care
• ISSN: 0163-8343
• DOI: 10.1016/j.genhosppsych.2017.03.002

Abstract Objective Primary care-based medical homes could improve the coordination of behavioral health care for individuals with schizophrenia and comorbid chronic conditions. The objective of this paper is to examine whether persons with schizophrenia and comorbid chronic conditions engage in primary care regularly, making primary care settings a viable mental health home. Method We examined the annual primary care and specialty mental health service utilization of adult North Carolina Medicaid enrollees with schizophrenia and at least one comorbid chronic condition who were in a medical home during 2007–2010. Using a fixed-effects regression approach, we also assessed the effect of medical home enrollment on utilization of primary care and specialty mental health care and medication adherence. Results A substantial majority (78.5%) of person-years had at least one primary care visit, and 17.9% had at least one primary care visit but no specialty mental health services use. Medical home enrollment was associated with increased use of primary care and specialty mental health care, as well as increased medication adherence. Conclusions Medical home enrollees with schizophrenia and comorbid chronic conditions exhibited significant engagement in primary care, suggesting that primary-care-based medical homes could serve a care coordination function for persons with schizophrenia.