Grant: Cat Gr: Policy Research for HST -SPOR-Patient-Oriented Health Care Systems Res.

Individuals with severe mental illness (SMI), such as psychosis and bipolar disorder, are disproportionately affected by comorbid chronic health conditions, including cancer, cardiovascular disease and diabetes, and die 10-20 years younger than the general population. While primary care services remain the main point of access for Canadians, it is very difficult for individuals with SMI to engage in these services due to access barriers, pervasive stigma, and the unique needs in this population. Recognizing that specialized mental health services are the 'de-facto' health home for individuals with SMI, leading health systems are integrating physical health monitoring within specialty mental health services through policy development and organizational standards. This study, guided by a national Patient and Family Advisory Council (PFAC), aims to provide feasible, acceptable, safe, effective, and patient centered policy options to support the delivery of integrated physical and mental health care in mental health settings in Canada and decrease health disparities for this population. A 3-phase knowledge mobilization approach will be used. The first phase will include a comparative policy analysis of Canadian and international policies and organizational approaches supporting the delivery of physical health care to this population. At the same time, qualitative interviews will be conducted with patients, clinicians, and other stakeholders, to understand their needs, perspectives and experiences towards integrating physical health care in mental health settings for individuals with SMI. In Phase 2, policy options will be discussed with a diverse group of stakeholders in a virtual policy workshop, to refine the policy options that would work in Canadian settings and with diverse populations with SMI. Lastly, in phase 3, top policy recommendations will be finalized and disseminated to internal and external stakeholders, under the guidance of the PFAC.