Evidence map›Paper›PMID 34346734›Full record

ArticlePsychiatric services (Washington, D.C.)2022

Assessing the Long-Term Effectiveness of a Behavioral Health Home for Adults With Bipolar and Psychotic Disorders.

Karl Johnson, Miriam Tepper, H Stephen Leff, Brian O Mullin, Benjamin L Cook, Ana M Progovac

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Psychiatric services (Washington, D.C.), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 2 pooled it
0.2field-weighted citation impact, top 51% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 2 syntheses or guidelines pooled it, 3 citations in OpenAlex.

  1. Increasing uptake of physical health checks for people living with severe mental illness: a systematic review.The British journal of general practice : the journal of the Royal College of General Practitioners · 2026
    Pooled it
  2. Pooled it
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 1 institution in 1 country.

Karl JohnsonDepartment of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina, Chapel Hill (Johnson); Department of Psychiatry, Cambridge Health Alliance, Cambridge, Massachusetts (Tepper, Leff, Mullin, Cook, Progovac); Department of Psychiatry, Harvard Medical School, Boston (Tepper, Leff, Cook, Progovac).ORCID 0000-0002-9983-0260
Miriam TepperDepartment of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina, Chapel Hill (Johnson); Department of Psychiatry, Cambridge Health Alliance, Cambridge, Massachusetts (Tepper, Leff, Mullin, Cook, Progovac); Department of Psychiatry, Harvard Medical School, Boston (Tepper, Leff, Cook, Progovac).
H Stephen LeffDepartment of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina, Chapel Hill (Johnson); Department of Psychiatry, Cambridge Health Alliance, Cambridge, Massachusetts (Tepper, Leff, Mullin, Cook, Progovac); Department of Psychiatry, Harvard Medical School, Boston (Tepper, Leff, Cook, Progovac).
Brian O MullinDepartment of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina, Chapel Hill (Johnson); Department of Psychiatry, Cambridge Health Alliance, Cambridge, Massachusetts (Tepper, Leff, Mullin, Cook, Progovac); Department of Psychiatry, Harvard Medical School, Boston (Tepper, Leff, Cook, Progovac).
Benjamin L CookDepartment of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina, Chapel Hill (Johnson); Department of Psychiatry, Cambridge Health Alliance, Cambridge, Massachusetts (Tepper, Leff, Mullin, Cook, Progovac); Department of Psychiatry, Harvard Medical School, Boston (Tepper, Leff, Cook, Progovac).
Ana M ProgovacDepartment of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina, Chapel Hill (Johnson); Department of Psychiatry, Cambridge Health Alliance, Cambridge, Massachusetts (Tepper, Leff, Mullin, Cook, Progovac); Department of Psychiatry, Harvard Medical School, Boston (Tepper, Leff, Cook, Progovac).
Cambridge Health Alliance · US

Funding

Harvard Clinical and Translational Science CenterUL1TR001102 · NCATS · HARVARD MEDICAL SCHOOL · PI NADLER, LEE MARSHALL · 2013 to 2017
$106.2M
NCATS NIH HHS UL1 TR001102
6 · The paper itself

Abstract

objectiveThis study aimed to examine the impact of a behavioral health home (BHH) to better understand its potential to improve health for individuals with serious mental illness.

methodsPropensity score-weighted interrupted time series analysis was used to estimate service utilization and chronic disease management through 3.5 years after BHH implementation and to compre BHH enrollees (N=413) with other patients with serious mental illness in the same health system (N=1,929).

resultsRelative to control group members, BHH patients had an immediate increase in primary care visits (+0.18 visits/month), which remained higher throughout follow-up, and an immediate decrease in emergency department visits (-0.031 visits/month). Behavioral health outpatient visits, which were increasing for BHH participants before implementation, began decreasing postimplementation; this decrease (-0.016 visits/month) was significantly larger than for the control group. Inpatient and outpatient visits for general medical health were decreasing over time for both groups before implementation but decreased more slowly for BHH patients postimplementation. Although behavioral health inpatient visits decreased for both groups around the start of the BHH program and remained lower, this initial drop was larger for the non-BHH group. BHH participation was associated with decreases in hemoglobin A1c values but no shift in low-density lipoprotein cholesterol values.

conclusionsThe results reflect the challenges of improving health for patients with serious mental illness, even as access to primary care is increased. Further study is needed about which complex interventions inside and outside of the health care system can help offset the 20- to 30-year mortality gap faced by this population.

Indexed as

Mental Health ServicesPsychiatryPsychotic DisordersAdultEmergency Service, HospitalHumansMedicaidBehavioral health homeMental health systems/hospitalsPrimary careSerious mental illness

Identifiers

PMID34346734
PMCPMC12714029
OpenAlexW3190838184

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.