Serious Mental Illness Toolkit

We have created a Serious Mental Illness (SMI) toolkit to serve as a resource to help members with a SMI diagnosis to become or remain stable. Mental illnesses are disorders that affect a person’s thinking, mood, and/or behavior –they range from mild to severe.

According to the National Institute on Mental Health, nearly one in five adults live with a mental illness. A mental illness that interferes with a person’s life and ability to function is called a serious mental illness (SMI). With the right treatment, people with SMI can live productive and enjoyable lives (SAMHSA, June 2002). Whether a patient is newly diagnosed with a SMI or has been living with a SMI diagnosis for a long time, providing them with additional resources and tools will be beneficial.

Looking for additional resources and tools to help educate and encourage members with SMI?

View our SMI Toolkit

Clinical Practice Guidelines

Clinical practice guidelines are designed to inform clinicians about best practices as they engage in shared decision-making to identify the right treatments for each patient. Providers can consider these guidelines together with their own expertise, keeping in mind a patient’s culture, preferences, and values. We hope this will be a useful tool for providers to have in their toolbox, to be used as part of an evidence-based practice in psychology.

Best Practices

The Department of Veterans Affairs is recognized as a top authority on behavioral services. They recommend the following principles to provide the most effective care:

  • Mental health services should be recovery-oriented
  • Mental health services should be provided in a therapeutically enriching environment
  • Mental health services should be provided in a safe and secure environment
  • Mental health services should be integrated and coordinated
  • Mental health services should be provided in settings that respect and can accommodate a diverse range of populations and care needs

Linking your patient with resources within their community is beneficial in helping them to expand their support system but also aid in their stabilization.

Co-Occurring Disorders

Researchers have found that about half of individuals who experience a SUD during their lives will also experience a co-occurring mental disorder and vice versa. Co-occurring disorders can include anxiety disorders, depression, attention-deficit hyperactivity disorder (ADHD), bipolar disorder, personality disorder, and schizophrenia, which are some of the common diagnoses.

Medication Adherence Guidelines

Non-adherence to SMI treatment is associated with poor health outcomes, including psychiatric

hospitalization, relapse, negative social outcomes (e.g., arrest, job loss), and increased risk of

attempted suicide. Patients who maintain the correct medication regimen more effectively managed their mental health symptoms and improve their emotional wellbeing. The willingness to take medication also indicated patients’ confidence in the entire treatment process and the development of skills needed for living in recovery.

Providers can access the CareSource medications and formulary tool for Healthy Indiana Plan (HIP) at the following links:

Provider Resources/Screening Tools

Behavioral health services focus on whole-body, whole-person health. This means ensuring your patients are not only physically healthy, but also mentally and emotionally healthy.  Screening is an important part of coordinating care. Below are some screenings that can be very helpful to your patients and practice:

Care Coordination

Care coordination has been identified as an important way to improve how the healthcare system works for patients, especially in terms of improved efficiency and safety. Most importantly, care coordination applied in a targeted way has the potential for improved outcomes for patients, providers, and payers. CareSource understands that coordinated care is key to ensuring optimal outcomes for our members. We ensure that all of our providers have access to behavioral health resources and that behavioral health is integrated across all interventions.

Community Resources

SMI Members diagnosed with a SMI would benefit from being linked with a behavioral health provider for additional support and resources. Behavioral health providers within the CareSource network can be located using our Find A Doctor Tool.

Community Mental Health Centers

Members can also be linked with a Community Mental Health Center (CMHC) that can provide more intensive services, including individual therapy, case management, skills training, peer recovery, and club house to facilitate social skills. A list of CMHCs can be found at the Indiana Council website.

Medically Frail

Members with a SMI diagnosis and who are receiving HIP benefits should be assessed for a medically frail designation in order to access enhanced benefits which could include Medicaid Rehabilitation Option, dental services, non-emergency transportation, and chiropractic services.

An individual is considered medically frail if he or she has one or more of the following:

  • Disabling mental disorder
  • Chronic substance abuse disorder
  • Serious and complex medical condition
  • Physical, intellectual, or developmental disability that significantly impairs the individual’s ability to perform one or more activities of daily living, or
  • Disability determination from the Social Security Administration

CareSource, the member, or the provider can request a medically frail assessment at any time during the member’s benefit period:

  1. Members can self-identify through the following:
      • Customer Advocacy (844-607-2829)
      • 24 Hour Nurse Advice Line (1-866-206-7880)
    • Care Manager, Life Coach, or Community Health Worker
  2.  Providers can identify a member as medically frail through the following:
    • Provider Portal
    • Provider Services Line
  1. Fax MF referral form to 937-487-0131
  2. Email referral to MedicallyFrail@caresource.com