Contours of Usual Care: Meeting the Medical Needs of Diverse People with Serious Mental Illness

PURPOSE: To examine practices, barriers, and recommendations for addressing the physical health of racially and ethnically diverse people with serious mental illness (SMI). METHODS: Semi-structured interviews and participant observations were conducted with 21 administrators and 25 clinicians representing six mental health care organizations. Data were analyzed using constant comparative methods. RESULTS: Practices included intermittently collecting consumers' physical health data, connecting consumers with primary care, and providing on-site, culturally-tailored health promotion programs. Barriers included limited care coordination infrastructure, financial and professional boundaries, unhealthy local environments and culturally-specific dietary habits. Recommendations included: strengthening dialogue with medical providers and developing staff training programs. CONCLUSION: Meeting the physical health needs of diverse consumers with SMI is impeded by organizational, environmental, and consumer-level barriers. Establishing better care coordination networks, increasing mental health provider education on medical issues, and culturally-tailoring health promotion programming provide plausible strategies for improving the physical health of this vulnerable population.