Integrating Health and Mental Health Treatment

It is well known that homeless people with severe mental illness have behavioral risk factors such as alcohol and drug use, tobacco use, and obesity. Often they have sought health care through hospital emergency departments and inpatient services for lack of access to primary care (Kushel et al., 2001). The Medicaid expansion provision of the Affordable Care Act (ACA/Obamacare) offers new opportunities for health insurance coverage for homeless people. A stable funding source can enable greater access to general medical care for people with severe mental illness by integrating primary care and behavioral health services (Druss et al.,

2001; Pollard et al., 2014; Smith et al., 2013). Services integration could also have the effect of reducing mental health stigma (Shim & Rust, 2013), encouraging greater numbers of people suffering from mental illness to seek treatment. If service innovation following the implementation of the ACA develops, systems integration approaches developed through the ACA, such as health homes, could be enhanced by efforts to support and empower individuals with severe mental illness to successfully navigate the health care system and embrace “self-management” of their health conditions (Kelly et al., 2014).

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