Objective: Despite the prevalence of medical comorbidity in persons with SMI, few studies have examined the factors that predict utilization of medical care for this population. Community mental health services are a primary support mechanism that may influence access to general medical care, thereby avoiding aggravating physical conditions and hospitalization. This analysis used quantitative and qualitative methods to examine the impact of mental health services on receipt of medical care from general practitioners (GP) for persons with SMI.

Methods: A random sample of 252 persons with SMI participating in supported housing programs in a large urban community was interviewed as part of an NIMH-funded protocol. These interviews asked participants to self-report demographic information, physical health status and functioning, symptoms of mental illness, contact with residential support staff and receipt of mental health case management services. An adjusted Poisson regression model was used to examine the impact of these variables on the number of GP visits made in the past year.

Building on the results of the quantitative analysis, two focus groups (N=14) were conducted with residents of supported housing programs to elicit the ways in which community mental health service providers assist these individuals with utilizing medical services.

Results: Only 10% of the sample did not visit a GP in the past year with females significantly less likely than males to visit their GP (85% versus 94%, p=.015). Adjusted Poisson analyses controlling for physical health status, severity of mental health symptoms, and psychiatric diagnosis indicated that being male, over 40, White, and involved with case management increased visits to the GP in the past year by 41% (p=.0001), 44% (p=.007), 17% (p=.0001), and 13% (p=.03), respectively.

Content analysis of focus group transcripts indicated residential support staff and mental health case managers facilitate the receipt of medical care for persons with SMI by 1) mandating yearly medical visits as a condition of participation in supported housing, 2) making medical appointments for consumers, 3) attending medical appointments with consumers, and 4) regular assessment of physical health status.

Conclusion and Implications: Community mental health services may be an effective mechanism for monitoring physical health conditions and assisting with access to general medical care for persons with SMI. Future studies should explore the ways in which these services impact physical health outcomes. Such research efforts are important for informing the design of interventions to strengthen the links between mental health and physical health services in order to improve the physical well-being of persons with SMI.