Behavioral and Medical Comorbidity: Identifying Challenges and Transforming Systems of Care

Prevalence of medical comorbidity is much higher for people with serious mental illness than it is for the general population. People with mental illness die 14 to 18 years prematurely, largely due to common causes of death including cerebrovascular disease, diabetes, and cancer. For instance, behavioral health disorders are the leading cause of disease burden in the U.S. There has been a historic separation between the systems which address behavioral health, and the medical care system which addresses other health issues. These systems differ in organization and financing and are represented by separate institutions and different professions. In addition, behavioral disorders are frequently criminalized; rather than receiving treatment, sufferers are incarcerated. Effective medical management, social support, and patient experience are greatly enhanced when behavioral health, primary care, and other medical services are integrated, with the healthcare system in the U.S. for example, which is just beginning to make progress toward this goal.

The nation faces a behavioral health crisis that is fueling declining life expectancy for the first time in more than a century, largely attributable to substance use disorder and suicide; incarceration, homelessness, and a growing population of people with behavioral health needs stuck in long term care facilities and hospitals that are not equipped to meet their needs; and stigmatization and poor treatment of people with behavioral health needs in primary, specialty and acute care. Considering these points, the goal of this Research Topic is to present the latest innovations in behavioral health integration, and the relevant historical, social, and policy context, to inform advances in policy and practice.

Globally applicable submissions are welcome into this collection, with submissions that are informative about the situation in the U.S. of particular interest. Submission may include historical, epidemiological, and causal research on behavioral and medical comorbidity as context. The following topics are welcomed into this collection, but not limited to:

- Behavioral health integration in primary care medical settings;

- Prevention (or substance abuse prevention) in community and medical settings;

- Epidemiology of behavioral and medical comorbidity across the life course (e.g., evaluations of interventions and models for behavioral health integration, including settings across the life course, specialties, and systems of care: reproductive health, pediatrics, adolescence, family systems, adulthood, acute care, post-acute care, long term care, and geriatrics);

- Disparities in care and achieving health equity;

- Responding to the needs of vulnerable and marginalized populations (e.g., people with criminal justice involvement, unhoused people, people who engage in sex work, and others, and their family and friends);

- Inclusion and support for caregivers and families;

- Perspectives of individuals affected by the issues (i.e., including people with lived experience).

The following article types will be considered for this collection: Brief Research Report, Clinical Trial, Community Case Study, Data Report, General Commentary, Mini Review, Original Research, Policy Brief, Policy and Practice Reviews, and Systematic Review.