Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences (Mangurian, Thomas, Mitsuishi, Niu, Riano, Hwong, Dilley), and Department of Epidemiology and Biostatistics (Mangurian, Handley), University of California, San Francisco (UCSF); Division of General Internal Medicine, Department of Medicine, San Francisco General Hospital (Goldman, Handley, Schillinger); Department of Psychiatry, Columbia University, New York City (Essock); Department of Psychiatry, Washington University School of Medicine, St. Louis, and Thriving Mind South Florida, Miami (Newcomer). Benjamin G. Druss, M.D., M.P.H., and Gail Daumit, M.D., M.H.S., are editors of this column.
Psychiatr Serv. 2022 Aug 1;73(8):942-945. doi: 10.1176/appi.ps.202100177. Epub 2022 Feb 9.
The authors sought to describe a reverse-integration intervention aimed at improving preventive health screening in a community mental health clinic. The intervention, CRANIUM (cardiometabolic risk assessment and treatment through a novel integration model for underserved populations with mental illness), integrated primary care services into a large urban community mental health setting. It was implemented in 2015 and included a patient-centered team, population-based care, emphasis on screening, and evidence-based treatment. CRANIUM's strengths included provider acceptability, a patient-centered approach, sustained patient engagement, and economic feasibility. Challenges included underutilized staff, registry maintenance, and unanticipated screening barriers. The CRANIUM reverse-integration model can be feasibly implemented and was acceptable to providers.
作者旨在描述一种反向整合干预措施，旨在改善社区心理健康诊所的预防保健筛查。该干预措施名为“CRANIUM”（通过针对患有精神疾病的服务不足人群的新型整合模式进行心脏代谢风险评估和治疗），将初级保健服务整合到大型城市社区心理健康环境中。它于 2015 年实施，包括以患者为中心的团队、基于人群的护理、强调筛查以及基于证据的治疗。CRANIUM 的优势包括提供者的可接受性、以患者为中心的方法、持续的患者参与和经济可行性。挑战包括利用率低的员工、登记册维护和意外的筛查障碍。CRANIUM 反向整合模型是可行的，并且得到了提供者的认可。
