Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore (McGinty, Presskreischer); RAND Corporation, Pittsburgh (Breslau) and Boston (Horvitz-Lennon); Mathematica, Washington, D.C. (Brown); Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina, Chapel Hill (Domino); Department of Health Policy and Management, Rollins School of Public Health, Emory University, Atlanta (Druss); Division of General Internal Medicine, Johns Hopkins School of Medicine, Baltimore (Murphy, Daumit); Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York City (Pincus).
Psychiatr Serv. 2021 Nov 1;72(11):1301-1310. doi: 10.1176/appi.ps.202000768. Epub 2021 Jun 2.
People with serious mental illness die 10-20 years earlier, compared with the overall population, and the excess mortality is driven by undertreated physical health conditions. In the United States, there is growing interest in models integrating physical health care delivery, management, or coordination into specialty mental health programs, sometimes called "reverse integration." In November 2019, the Johns Hopkins ALACRITY Center for Health and Longevity in Mental Illness convened a forum of 25 experts to discuss the current state of the evidence on integrated care models based in the specialty mental health system and to identify priorities for future research, policy, and practice. This article summarizes the group's conclusions. Key research priorities include identifying the active ingredients in multicomponent integrated care models and developing and validating integration performance metrics. Key policy and practice recommendations include developing new financing mechanisms and implementing strategies to build workforce and data capacity. Forum participants also highlighted an overarching need to address socioeconomic risks contributing to excess mortality among adults with serious mental illness.
与一般人群相比，患有严重精神疾病的人群的预期寿命会减少 10 到 20 年，造成这种超额死亡率的原因是其身体健康状况未得到充分治疗。在美国，人们越来越关注将提供、管理或协调医疗服务的模式融入专业精神卫生项目的模式，有时被称为“逆向整合”。2019 年 11 月，约翰霍普金斯大学心理健康与长寿 ALACRITY 中心召集了一个由 25 名专家组成的论坛，讨论了基于专业精神卫生系统的综合护理模式的现有证据状况，并确定了未来研究、政策和实践的优先事项。本文总结了该小组的结论。关键的研究重点包括确定多组分综合护理模式中的有效成分，并制定和验证整合绩效指标。关键的政策和实践建议包括制定新的融资机制和实施策略，以建立劳动力和数据能力。论坛参与者还强调，需要解决导致严重精神疾病成年人死亡率过高的社会经济风险这一首要问题。
