Factors to Improve Reverse Integration: A Mixed Method Embedded Design Study

Aundrea Burner, Carol Wahl, Leeza Struwe

Research output: Contribution to journalArticlepeer-review


Individuals with serious mental illness face inequity in receiving primary care services. The Substance Abuse and Mental Health Services Administration (SAMHSA) granted funds to Certified Community Behavioral Health Clinics (CCBHC) to integrate primary care and behavioral health specialties to increase access to care. This mixed method study aimed to measure the SAMHSA-defined levels of reverse integration at a CCBHC at one point in time. Providers and patients provided feedback through semi-structured interviews. Qualitative data was investigated for themes, while the quantitative data was run through inferential analysis with the Kruskal Wallis H test. Clinically meaningful results showed people using primary care at the integrated clinic were more satisfied and were more apt to continue seeing their current providers than those receiving non-integrated care. The CCBHC achieved level 4 integration; factors investigated confirmed proximity alone does not necessitate integration without effective communication and implementation of practice changes.

Original languageEnglish (US)
Pages (from-to)525-535
Number of pages11
JournalCommunity Mental Health Journal
Issue number3
StatePublished - Apr 2024


  • Integration
  • Reverse integration
  • Serious mental illness (SMI)

ASJC Scopus subject areas

  • Health(social science)
  • Public Health, Environmental and Occupational Health
  • Psychiatry and Mental health


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