RESUMO
BACKGROUND: Mental health is a public health priority among chronic diseases in France and the United States. Although there is room for progress in France, the experience of Intermountain Healthcare (IH), Utah, in the United States can provide convincing experimental data. AIM: To identify the lessons learned from IH clinical integration of mental health specialists in primary care practices called "Mental Health Integration" (MHI) which might be useful in France. METHODS: This research is based on qualitative analysis of data derived from collaborative work with IH experts, literature searches, and item queries on the 3 objectives of the Triple Aim of the Institute for Healthcare Improvement (IHI). RESULTS: The MHI programme was developed to achieve IHI T riple AIM: improving user satisfaction; improving access of care and the health of the population; reducing health care costs per capita. By integrating mental health specialists within a multidisciplinary team headed by primary care physicians and working under the same roof with care managers and support staff, the MHI model enhances the process of the Chronic Care Model. Furthermore MHI has become the foundation for team-based care centered on the patient and theirfamily over the continuum of care by offering a global and structured evidenced-based care process. Prevention and integration of specialized care have been developed. Users and their families are co-responsible for their health. Discussion: Evaluation is systematic and based on specific indicators. The efficiency and clinical and organizational effectiveness created generate savings for health insurance as well as improved access to care and health equality.
