Wellness Program for SMI Population Seeks Positive Outcomes
Mental Health Weekly January 23, 2012
Addressing the increased morbidity and mortality rates that can be found in consumers with serious mental illness with prevention and wellness activity and access to primary care services, Centerstone of Indiana officials reported positive outcomes including weight loss and reduced blood sugar levels from a pilot program targeted BE Well (Building Exceptional Wellness) program is designed to improve the overall health, wellness
and quality of life for adults with serious mental illnesses in Monroe County, Ind.
BE Well provides primary healthcare, screening and assessments, care management, prevention and wellness support. Launched in January 2011, the services, and infrastructure and helps them track their progress in order to improve their health status.
Centerstone officials implemented the program following receipt of a four-year, $2 million grant from the Substance Abuse and Mental Health
Services Administration (SAMHSA). The not-for-profit organization, with more than 60 facilities in Indiana, was one of 64 organizations to receive
the Primary and Behavioral Health Care Integration program grant in September 2010 to coordinate and integrate primary care services into publicly funded community-based mental health settings.
From baseline to six months in the program, more than 50 patients have lost an average of 11.97 pounds per person. Over that time other positive
health indicators revealed a significant reduction in fasting blood sugar levels, according to John Putz, program evaluation associate at Centerstone.
“We’re expecting to see even more weight loss among patients,” going forward, Putz told MHW.
Participants in the program are starting to socialize more with one another and exercising together and walking together around the housing development where they live, he said. “They’re getting more social support with one another other than from their counselor or case worker,” said Putz. Program officials are starting to pay more attention to these social factors, he noted.
Centerstone plans to team up with the Indiana School of Health, Physical Education and Recreation to address the emotional benefits of social supports among consumers with serious mental illness, he said.
“We want to treat the whole person using a holistic approach,” Maren Sheese, LCSW, program manager at Centerstone, told MHW.
“People are already comfortable in their mental health home. They can access a plethora of services in one building,” including pharmacy and
other services for their physical health care needs, she said.
Research indicates that 75 percent of the population with serious mental illness also experience co-occurring health problems, said Sheese. “Our goal is to increase their physical health status so that the risk of early mortality is reduced,” she said. The program reflects a [natural] extension of the
organization’s services, said Sheese, particularly with health reform’s emphasis on integrated care and preventive services.
Centerstone’s goal is to enroll about 250 consumers in the program by the time the grant funding ends, she said. The program currently has 80 members, she said.
Other program stats include:
• 58.5 percent have hypertension.
• 46 percent have dependency on tobacco use.
• 44 percent have asthma.
• 41 percent have diabetes.
• 41 percent have dyslipidemia.
The program features psychoeducation for consumers with diabetes. Many of the participants participate in local walking or in aquatic activities at the YMCA, said Sheese. Cooking classes, a food and fitness group and a “Get Fit Chick” program round out the activities, she said.
Program officials say long-term goals include achieving a 50 percent reduction of physical health symptoms and reduced ER visits by 75 percent, said Sheese.
The program’s multidisciplinary team includes Marin, a nurse practitioner, a physician, two nurses, a care manager, a certified recovery specialist/
rehabilitation specialist (formerly referred to as case managers), and an office professional.
The BE Well program, said Sheese, initiative targets five areas:
3. Dyslipidemia (high blood cholesterol levels).
4. Nicotine dependence.
The participants have to experience symptoms in at least one target area and be motivated enough to want to change their condition, added
Centerstone last month announced the receipt of another SAMHSA grant, this one a one-year $200,000 technical grant supplement to expand the use of health information technology to improve health outcomes through its BE Well program.
With the new technical grant supplement, Centerstone will expand its software and electronic health record use for 250 BE Well program participants and identify both their behavioral health and primary care needs, according to Centerstone program officials.
The grant also will ensure that patient outcomes are tracked more efficiently and information can be shared more easily with physical health providers, including physicians, pharmacists, and medical laboratories, to enhance preventative health efforts across both mental and physical healthcare settings, they said. “One of the biggest challenges is keeping up with changes in the industry,” Sheese said. “Technology is a big piece.”
Continuity of care treatment coordination is another goal related to the technical grant, she noted. “We share continuity of care records between
the center and the physical health care providers,” Sheese said.
“We want to achieve interoperability and extend our current EHR,” she said. Centerstone generates and transmits 40 percent of its prescriptions
electronically, she added. The organization also receives 80 percent of its lab results electronically, she noted.
“Overall, we’re seeing a huge improvement and success in people feeling better about themselves,” said Sheese. •