Primary and behavioral health care integration: expanding access for underserved communities - rhode island experiences high rates of mental illness and substance use among underserved populations

The focus of the project "primary and behavioral health care integration: expanding access for underserved communities" is to implement integrated care services for the lesbian, GAY, bisexual, transgender and queer (lgbtq+) community with a focus on individuals who identify as hispanic/latinx and other underserved populations (i.e., those who experience unstable housing). Specific populations will include adults with serious mental illness (SMI), adults who have a CO-occurring mental illness and physical health condition or chronic disease, individuals with a substance use disorder (SUD), and individuals with CO-occurring disorders (COD). The overall goal of the proposed program is to implement bidirectional integrated care services, including evidence-based screening, assessment, diagnosis, prevention, treatment, and recovery services for mental health and substance use disorders, and CO-occurring physical health conditions and chronic diseases such as HIV, sexually transmitted infections (STIS), and chronic hepatitis C virus (HCV) infection. The proposed project will aim to develop culturally congruent approaches to providing these comprehensive services for the lgbtq+ community in providence, rhode island, the epicenter of mental illness, substance use, HIV and other chronic diseases in the state. At the present time, there are no integrated programs for mental health, substance use, and primary care for the lgbtq+ community in rhode island. In response to this unmet need and to address disparities among lgbtq+, hispanic/latinx, and unstably housed individuals, the rhode island department of health (RIDOH) is partnering with rhode island public health institute (RIPHI), open door health (the only community-based lgbtq+ clinic in the state), the providence center (the main and largest community-based behavioral health center in providence) and the miriam hospital, a major brown university affiliate. The goals of the project include providing clinic- and community-based health screenings for lgbtq+, hispanic/latinx, and other underserved communities (goal 1), providing comprehensive community-based mental health and substance use services for lgbtq+, hispanic/latinx, and other underserved communities (goal 2), and providing community-based primary care and other specialty care for lgbtq+, hispanic/latinx, and other underserved communities (goal 3). We aim to screen over 1,000+ unique individuals annually (5,000+ total during the project) and enroll approximately 125 at-risk individuals annually (625 total during the project).