Strengthening the delivery of integrated physical health care for adults experiencing serious mental illness: a scoping review of interventions in mental health settings

Individuals living with serious mental illness (SMI) face significant barriers to accessing appropriate physical health care, poorer associated health outcomes and premature mortality compared to the general population. This scoping review examines service delivery models and clinical practices supp...

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Main Authors: Munazzah Ambreen, Sihan Zhang, Osnat C. Melamed, Christopher Canning, Brian Lo, Sri Mahavir Agarwal, Amer M. Burhan, M. Elisabeth Del Giudice, Mary Rose van Kesteren, Barna Konkolÿ Thege, Sanjeev Sockalingam, Terri Rodak, Tania Tajirian, Caroline Walker, Vicky Stergiopoulos
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-06-01
Series:Frontiers in Health Services
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Online Access:https://www.frontiersin.org/articles/10.3389/frhs.2025.1570100/full
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author Munazzah Ambreen
Sihan Zhang
Osnat C. Melamed
Osnat C. Melamed
Christopher Canning
Christopher Canning
Brian Lo
Brian Lo
Sri Mahavir Agarwal
Sri Mahavir Agarwal
Amer M. Burhan
Amer M. Burhan
M. Elisabeth Del Giudice
Mary Rose van Kesteren
Barna Konkolÿ Thege
Barna Konkolÿ Thege
Sanjeev Sockalingam
Sanjeev Sockalingam
Terri Rodak
Tania Tajirian
Tania Tajirian
Caroline Walker
Vicky Stergiopoulos
Vicky Stergiopoulos
Vicky Stergiopoulos
author_facet Munazzah Ambreen
Sihan Zhang
Osnat C. Melamed
Osnat C. Melamed
Christopher Canning
Christopher Canning
Brian Lo
Brian Lo
Sri Mahavir Agarwal
Sri Mahavir Agarwal
Amer M. Burhan
Amer M. Burhan
M. Elisabeth Del Giudice
Mary Rose van Kesteren
Barna Konkolÿ Thege
Barna Konkolÿ Thege
Sanjeev Sockalingam
Sanjeev Sockalingam
Terri Rodak
Tania Tajirian
Tania Tajirian
Caroline Walker
Vicky Stergiopoulos
Vicky Stergiopoulos
Vicky Stergiopoulos
author_sort Munazzah Ambreen
collection DOAJ
description Individuals living with serious mental illness (SMI) face significant barriers to accessing appropriate physical health care, poorer associated health outcomes and premature mortality compared to the general population. This scoping review examines service delivery models and clinical practices supporting the integration of physical health care for adults with SMI within mental health settings, and their outcomes. Searches of four academic databases yielded 65 academic articles. Most integrated service delivery models were implemented in community mental health settings in the United States and incorporated elements of Wagner's Chronic Care Model, emphasizing delivery-system redesign, patient self-management support and use of clinical information systems. In most outcome studies, integrated care models were associated with improvements in primary care access and preventative screening rates, while other physical health indicators and emergency and inpatient service use demonstrated promising but mixed results. Implementation challenges of integrated service delivery models included securing financial resources and maintaining effective use of clinical information systems, among others. Successful implementation was facilitated by effective teamwork, care coordination, and administrative and leadership support. Study findings highlight the complexity of integrating physical health care in mental health settings, and the longer timeframes needed to observe changes in some outcomes. The review further underscores the need for ongoing efforts to advance integrated care delivery in mental health settings and the importance of longitudinal data collection to fully assess and optimize the implementation and outcomes of these interventions.Systematic Review Registration:https://doi.org/10.17605/OSF.IO/3T9VK.
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spelling doaj-art-f33be2505aef40f6a6e1bfdd1887fbf42025-08-20T03:47:20ZengFrontiers Media S.A.Frontiers in Health Services2813-01462025-06-01510.3389/frhs.2025.15701001570100Strengthening the delivery of integrated physical health care for adults experiencing serious mental illness: a scoping review of interventions in mental health settingsMunazzah Ambreen0Sihan Zhang1Osnat C. Melamed2Osnat C. Melamed3Christopher Canning4Christopher Canning5Brian Lo6Brian Lo7Sri Mahavir Agarwal8Sri Mahavir Agarwal9Amer M. Burhan10Amer M. Burhan11M. Elisabeth Del Giudice12Mary Rose van Kesteren13Barna Konkolÿ Thege14Barna Konkolÿ Thege15Sanjeev Sockalingam16Sanjeev Sockalingam17Terri Rodak18Tania Tajirian19Tania Tajirian20Caroline Walker21Vicky Stergiopoulos22Vicky Stergiopoulos23Vicky Stergiopoulos24Centre for Addiction and Mental Health, Toronto, ON, CanadaCentre for Addiction and Mental Health, Toronto, ON, CanadaCentre for Addiction and Mental Health, Toronto, ON, CanadaDepartment of Family and Community Medicine, University of Toronto, Toronto, ON, CanadaWaypoint Research Institute, Waypoint Centre for Mental Health Care, Penetanguishene, ON, CanadaDepartment of Psychiatry, University of Toronto, Toronto, ON, CanadaCentre for Addiction and Mental Health, Toronto, ON, CanadaInstitute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, CanadaCentre for Addiction and Mental Health, Toronto, ON, CanadaDepartment of Psychiatry, University of Toronto, Toronto, ON, CanadaDepartment of Psychiatry, University of Toronto, Toronto, ON, CanadaOntario Shores Centre for Mental Health Sciences, Whitby, ON, CanadaDepartment of Family and Community Medicine, University of Toronto, Toronto, ON, CanadaCentre for Addiction and Mental Health, Toronto, ON, CanadaWaypoint Research Institute, Waypoint Centre for Mental Health Care, Penetanguishene, ON, CanadaDepartment of Psychiatry, University of Toronto, Toronto, ON, CanadaCentre for Addiction and Mental Health, Toronto, ON, CanadaDepartment of Psychiatry, University of Toronto, Toronto, ON, CanadaCentre for Addiction and Mental Health, Toronto, ON, CanadaCentre for Addiction and Mental Health, Toronto, ON, CanadaDepartment of Family and Community Medicine, University of Toronto, Toronto, ON, CanadaCentre for Addiction and Mental Health, Toronto, ON, CanadaCentre for Addiction and Mental Health, Toronto, ON, CanadaDepartment of Psychiatry, University of Toronto, Toronto, ON, CanadaInstitute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, CanadaIndividuals living with serious mental illness (SMI) face significant barriers to accessing appropriate physical health care, poorer associated health outcomes and premature mortality compared to the general population. This scoping review examines service delivery models and clinical practices supporting the integration of physical health care for adults with SMI within mental health settings, and their outcomes. Searches of four academic databases yielded 65 academic articles. Most integrated service delivery models were implemented in community mental health settings in the United States and incorporated elements of Wagner's Chronic Care Model, emphasizing delivery-system redesign, patient self-management support and use of clinical information systems. In most outcome studies, integrated care models were associated with improvements in primary care access and preventative screening rates, while other physical health indicators and emergency and inpatient service use demonstrated promising but mixed results. Implementation challenges of integrated service delivery models included securing financial resources and maintaining effective use of clinical information systems, among others. Successful implementation was facilitated by effective teamwork, care coordination, and administrative and leadership support. Study findings highlight the complexity of integrating physical health care in mental health settings, and the longer timeframes needed to observe changes in some outcomes. The review further underscores the need for ongoing efforts to advance integrated care delivery in mental health settings and the importance of longitudinal data collection to fully assess and optimize the implementation and outcomes of these interventions.Systematic Review Registration:https://doi.org/10.17605/OSF.IO/3T9VK.https://www.frontiersin.org/articles/10.3389/frhs.2025.1570100/fullserious mental illnessintegrated carereverse integrationpremature mortalityservice delivery
spellingShingle Munazzah Ambreen
Sihan Zhang
Osnat C. Melamed
Osnat C. Melamed
Christopher Canning
Christopher Canning
Brian Lo
Brian Lo
Sri Mahavir Agarwal
Sri Mahavir Agarwal
Amer M. Burhan
Amer M. Burhan
M. Elisabeth Del Giudice
Mary Rose van Kesteren
Barna Konkolÿ Thege
Barna Konkolÿ Thege
Sanjeev Sockalingam
Sanjeev Sockalingam
Terri Rodak
Tania Tajirian
Tania Tajirian
Caroline Walker
Vicky Stergiopoulos
Vicky Stergiopoulos
Vicky Stergiopoulos
Strengthening the delivery of integrated physical health care for adults experiencing serious mental illness: a scoping review of interventions in mental health settings
Frontiers in Health Services
serious mental illness
integrated care
reverse integration
premature mortality
service delivery
title Strengthening the delivery of integrated physical health care for adults experiencing serious mental illness: a scoping review of interventions in mental health settings
title_full Strengthening the delivery of integrated physical health care for adults experiencing serious mental illness: a scoping review of interventions in mental health settings
title_fullStr Strengthening the delivery of integrated physical health care for adults experiencing serious mental illness: a scoping review of interventions in mental health settings
title_full_unstemmed Strengthening the delivery of integrated physical health care for adults experiencing serious mental illness: a scoping review of interventions in mental health settings
title_short Strengthening the delivery of integrated physical health care for adults experiencing serious mental illness: a scoping review of interventions in mental health settings
title_sort strengthening the delivery of integrated physical health care for adults experiencing serious mental illness a scoping review of interventions in mental health settings
topic serious mental illness
integrated care
reverse integration
premature mortality
service delivery
url https://www.frontiersin.org/articles/10.3389/frhs.2025.1570100/full
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