PRIMARY-CARE FOR THOSE WITH SEVERE AND PERSISTENT MENTAL-ILLNESS

Historically, the medical care of persons with severe and persistent m ental illness (SPMI) has been suboptimal, In many communities, large g aps exist in the continuum of services necessary to meet the medical n eeds of those patients, and existing services are not well coordinated . The effect of the managed mental health care on patients with SPMI r emains to be seen, but it does not bode well for patients who are alre ady at risk for being undertreated. We initiated primary care clinics exclusively for patients with SPMI because of our belief that integrat ing primary care and mental health services offers the best hope of im proving health care for those patients. Our experience to date is inst ructive for other health care systems.