What started more than a decade ago with a few CON faculty bringing their students into a mental health care clinic has evolved into one of the most successful, long-standing community collaborations for the UIC College of Nursing. Recognizing that many of the primary healthcare needs of mental health patients were not being met, CON faculty and students began partnering with Thresholds, a Chicago nonprofit organization devoted to mental illness psychiatric rehabilitation and recovery, to provide primary care its members.

The “Integrated Health Care” (IHC) program is an innovative model that serves the primary care needs of patients suffering from mental health issues in the most obvious location – mental health rehabilitation settings.

“People with mental illness typically have worse healthcare problems, and problems with access to care because of cognitive disabilities and difficulty accessing services they need,” says Diane Pineda, CON nurse practitioner who works with the IHC program. “Going into the mental healthcare place is where the members feel most comfortable. The idea is to fully care for them as a person, taking care of physical health challenges in the context of mental illness.”

The IHC program, originally started as a one day a week clinic at one Thresholds site, has increased to several days a week at several sites around the city. Besides support from the College of Nursing and Thresholds, various sources of funding have included the generous donations of alumni and friends, the federal government Health Resources and Services Administration, and the Robert Wood Johnson Foundation.

The partnership works on many levels; on a day to day basis, it's the Thresholds case workers and staff who partner closely with nursing clinic staff to make sure each member gets comprehensive care, integrating primary physical with mental health care. Other partnerships developed along the way keep the core partnership strong.

This summer, the IHC clinics are employing a half dozen nurse practitioners, four of them CON faculty, including psychiatric nurses who practice and teach in the clinics. UIC family nurse practitioner students also experience serving in the IHC clinics. “We're teaching the students some of the special nuances of working with people with mental illness,” Pineda describes. “They're going to see people with every kind of mental illness in every clinic, even if they're not specifically treating the mental illness. It affects how you treat the rest of the person.”

Why has this partnership survived and succeeded for so long?

“It's like a marriage of two very different people,” describes Pineda. “There's the big university, and a community-based agency. There are struggles on a daily basis to understand each other when you come from very different backgrounds, mindsets, and disciplines. At the bottom of it all is a commitment to serve the members of Thresholds and work through those differences.”

She adds, “What would happen if we gave up? A lot of people wouldn't get the care they need.”

Latest News: Integrated Health Care Without Walls (IHC WOW) has received a $2M grant from Health Resources and Services Administration (HRSA).

As another practice model and part of our envisioned: Healthful Aging center, we in the College of Nursing are determining the feasibility of a clinical practice called the Program of All-inclusive Care for the Elderly (PACE) – for very frail elders, sponsored through the State and Centers for Medicare and Medicaid Services funding.

Your input? What innovative practice dimensions/roles do you see emerging for nurses?