People with a lived experience of a mental health condition have a reduced life expectancy of 11-30 years compared to the general population. This disparity in mortality has been said to be due to cardiovascular disease, obesity, and tobacco use. A critical strategy to improve health and impact early mortality rates in people with a lived experience of a mental health condition has been the creation of “health homes,” which aim to better coordinate care and improve the physical health of with a lived experience of a mental health condition by integrating primary healthcare within community-based behavioral healthcare –sometimes referred to as “reverse integration.”
Improved integration of the organization, financing, and delivery of primary care and behavioral health services has the potential to address longstanding systemic barriers to accessing care for people with a lived experience of a mental health condition. For instance, health homes may help people navigate the primary care and mental health systems and improve comprehensive screening and assessment. The promise of health homes to improve care and outcomes has stimulated numerous national and state initiatives.
This study reviewed published literature on health homes to examine their impact on cardiometabolic risk factors among adults with a lived experience of a mental health condition.
· Health homes may have a greater impact on outcomes if they include: standardized screening; peer support and self-management training; intervention components that target interdependent risk factors.
· Health homes are associated with increased rates of cardiometabolic screening and service use.
· Improvement in cardiometabolic risk factors varied across the studies and the clinical significance of these reductions is not clear.
· Co-location of services may not be enough to significantly impact cardiometabolic risk factors.