Improving outcomes for adults who suffer with long-term and serious mental illness is a critical issue for the patient, the patient’s community, and wider systems of care. Many states have adopted a legal designation of Serious Mental Illness (SMI), which removes barriers to continuous care that is designed to address substantial functional impairment over multiple life domains. These impairments often lead to an inability to maintain gainful employment, loss of social support, recurrent psychiatric hospitalizations, homelessness, incarceration, and coexisting substance use disorders. While not all states have the legal SMI designation, it is estimated that about 5% of the adult population suffers with a diagnosable mental, behavioral, or emotional disorder that causes significant functional impairment that markedly interferes with or limits one or more major life activities. The economic burden associated with community challenges places a substantial strain on healthcare resources.
Patients with a diagnosed serious mental illness (SMI), their families, and healthcare systems of care face obstacles to helpful benefits and services. These obstacles fall into three primary categories: funding for benefits and services, bureaucratic access challenges, and systems of care that fail to cooperate in the interest of providing needed benefits and services. Adverse outcomes are linked to lapses in access to medication, inadequate bed space in higher levels of care, and lack of substantial outpatient care. SMI is generally defined through diagnosis, disability, and duration, and includes disorders with psychotic symptoms and severe forms of other disorders such as major depression, panic disorder, and obsessive-compulsive disorder. SMI is also associated with increased early mortality risk and disability.
In this article, we explore strategies to improve outcomes for adults with a diagnoseable SMI. Our focus is on connected care.
The Burden of SMI: SMI is something that impacts millions of adults worldwide. It effects not only mental health but also the physical well-being of a person. Chronic illnesses like diabetes, respiratory problems, and cardiovascular diseases are more common among those with SMI. Additionally, the lack of coordination between mental health services and the judicial system and inadequate continued care between incarceration and community settings places communities at risk of crime and offenders at risk of continuing to cycle through the criminal justice system.
Improving Outpatient Care: Our goal of improving outpatient service delivery is supported by four primary outcomes. First, we want to improve the quality of life of this vulnerable population. By helping people with serious mental illness coexist in the community, they can realize a life purpose, engage in meaningful relationships, and contribute to society. Next, reducing recidivism among offenders with serious mental illness ensures the safety of our community. Many crimes committed by this population are subsequent crimes with multiple victims and result in short incarcerations followed by continuing criminal behavior. Reducing recidivism by offenders with serious mental illness will certainly lower costs associated with law enforcement, criminal defense, court proceedings, and incarceration. Finally, through service collaboration and advocacy, the clinical needs of this population may be addressed with a lower level of care which is less intrusive to the person and more cost effective to society.
A Community Approach: Procedure for improving outcomes in a community must involve both interagency collaboration and advocacy. This process requires both a micro and a macro intervention; our efforts to improve collaboration and advocacy must address the system of care simultaneous to addressing the needs of individual persons.
Here’s how it can enhance outcomes for adults with SMI:
Integrated Services: By integrating community systems of care such as the healthcare system, the education system, public safety, and the courts, connected care ensures a comprehensive assessment. This method acknowledges the unique strengths and needs of each person served. Collaboration between law enforcement, housing services, educational systems, social workers, psychiatrists, and primary care physicians must be encouraged by administrators.
Care Coordination: To have effective care coordination, providers need to have open communication with the sufferers. To treat both physical and mental health problems mental health experts collaborate with medical doctors. Moreover, regular check-ins, shared electronic health records, and joint treatment planning contribute to better outcomes in purposeful activity, housing, and relationships.
Promoting Health: Ideally, a small group of stakeholders can come together to create a plan that addresses barriers at different system levels. Sometimes advocacy associated with reducing stigma and educating stakeholders is the first step. For other communities, the first step is to determine the conduits for collaboration between agencies.
Evidence and Impact
System-Level Connections: Research shows that making system-level connections for physical and behavioral healthcare produces positive outcomes for individuals with SMI. These connections reduce fragmented care, enhance treatment adherence, and improve overall quality of life.
Reducing Hospitalizations: Connected care models have led to fewer inpatient psychiatric hospital days. By addressing physical health needs promptly, we prevent crises and reduce hospital admissions.
Conclusion
Connected care allows our combined efforts as educators, professionals, and administrators to significantly improve the lives of persons with SMI. We create the conditions for better results and a more humane healthcare system by encouraging teamwork, supporting integrated services, and placing a strong emphasis on health promotion.
Remember: Every connection matters—whether it’s between providers, disciplines, or individuals seeking support.
