Development and Implementation of a Referral Resource for a Multidisciplinary Team at an Urban Free Mental Health Clinic

Background:Approximately 30 million individuals in the United States are uninsured, and 11.2 million individuals are struggling with Serious Mental Illness (SMI). The lack of comprehensive health resources impedes uninsured and low-income individuals in reaching recovery. Free mental health clinics were formed to act as a safety net for this population, yet a 2015 systematic review found that the majority of student providers working in a free clinic did not know how to provide continuity of care for uninsured and low-income patients, and they requested an orientation regarding ongoing comprehensive care and these issues. Methods:A quality improvement project was developed to help increase providers' knowledge and awareness of available resources. Providers in an urban free mental health clinic were surveyed to identify gaps in knowledge. A referral resource and quick reference list were developed and presented to providers. The presentation included current data on uninsured rates, needs of the uninsured, and highlighted each available category within the resource. This project also sought to assess the satisfaction of the resource among providers and volunteers within this clinic setting by implementing a post-survey. Results: Out of 29 eligible staff members, 16 completed the pre-intervention survey, and 6 attended the intervention training and completed the post-intervention survey. Thirty-one percent of participants felt the clinic provided adequate resources prior to the intervention, and 83.3% following the intervention. Provider's perception of their referral rate appeared to increase with majority reported referrals 25-50% before the intervention and 50-100% of the time post-intervention. Conclusions: Providers lacked knowledge and awareness of referral resources within this urban free mental health clinic. Barriers to comprehensive health care include a lack of awareness of referral resources, medical insurance, and low-income status. The implementation of a referral resource appeared to improve the barrier to providing continuity of care.