Differences in Patient-Reported Outcomes among Persons with Serious Mental Illness Receiving Integrated Primary and Behavioral Healthcare in Community Mental Health Centers
Open AccessThis study examined heterogeneity in treatment effects across subgroups, among individuals with serious mental illness receiving integrated primary and behavioral healthcare in Community Mental Health Centers. The primary objectives were to (1) assess the effects of race or ethnicity, age, and gender on mental health functioning and overall health outcomes; (2) assess the influence of comorbid substance use disorders and post-traumatic stress on the effects of race or ethnicity, age, and gender on mental health functioning and overall health outcomes; and (3) assess the influence of the type of services received on the effects of race or ethnicity, age, and gender on mental health functioning and overall health outcomes.The Adult Consumer Outcome Measures for Discretionary Programs data from 2009 to 2015 were analyzed for this study. Data were collected from mental health services consumers aged 18 or older, diagnosed with a serious mental illness, and receiving integrated primary and behavioral healthcare in Community Mental Health Centers. The study population was followed for 6 months to 42 months. Multivariate logistic regression was used to analyze the associations between the demographic, clinical, and treatment outcome variables.For mental health functioning, there were statistically significant differences in treatment effects for race or ethnicity, gender, and age. Black consumers, Asian consumers, and Alaska Native consumers were less likely than non-Hispanic Whitesto report improved mental health functioning. For some races, Asians and American Indians, this association was mediated by comorbid Substance Use Disorders, and post-traumatic stress. Older consumers were more likely to report improved mental health functioning compared to 18-25 year olds, and this association was not mediated by comorbidity or the type of services received. Women were also more likely to report improved mental health functioning, compared to men, and this association was not mediated by comorbidity or the type of service received.For overall health, there were statistically significant differences in treatment effects for race or ethnicity, gender, and age; but none of these associations were mediated by comorbidity or the type of services received. Black consumers, Native Hawaiian consumers, and Alaska Native consumers were more likely compared to non-Hispanic Whites, to report improved overall health. Hispanic consumers were less likely, compared to non-Hispanic Whites to report improved overall health. Older consumers were more likely to report improved overall health compared to 18-25 year olds, and women were less likely than men to report improved overall health.
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