UMass Chan Medical School Faculty Publications


The First Step in Health Reform for Those With Serious Mental Illness: Integrating the Dis-Integrated Mental Health System

UMMS Affiliation

Department of Psychiatry, Systems and Psychosocial Advances Research Center

Publication Date


Document Type



Health Policy | Health Services Administration | Mental Disorders | Psychiatry


Increasing attention is being directed toward meeting the psychiatric and medical needs of persons with persistent or recurrent mental illness through the integration of behavioral and medical healthcare. There are many models being considered or tested to achieve this objective. These models, however, generally ignore the challenge of integrating systems that are themselves dis-integrated. Also ignored is the fact that many persons with persistent or recurrent mental illness operate in the context of an array of entitlements; receive "services" from the criminal justice, as well as the health and behavioral health systems; and all these systems are both siloed and fail to meet the needs of this population. This article examines the current state of the cornucopia of services available to individuals with persistent or recurrent mental illness inclusive of federal statutes and policies to impact these services. Recommendations are made to move the dis-integrated system of mental health services toward an internally integrated system that would have the capacity to become integrated with a medical system of care and treatment to achieve a behavioral-medical integrated health delivery system.

DOI of Published Version



J Nerv Ment Dis. 2015 Dec;203(12):909-918. Link to article on publisher's site

Related Resources

Link to Article in PubMed

Journal/Book/Conference Title

The Journal of nervous and mental disease

PubMed ID