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Diabetes and Mental Illness
Continuity of Primary Care Saves Lives
Diabetes is a Serious Health Risk
Mental illness is not “just another co-morbidity.” The impact on worsening diabetes of any one behavioral health disorder is generally as great or greater than having 3 or even 4 other medical comorbidities
The one system of care variable that changes the risk of developing worse diabetes relates to continuity of primary care.  Fragmentation of primary care at baseline and moving from continuous to fragmented care in follow-up is associated with worse diabetes, while a  move from fragmented to continuous care appears protective.
Persons with Serious Mental Illness (SMI), Non SMI Mental Illness and dual diagnosis (a mental health and substance abuse diagnosis) have higher rates of diabetes, pre-diabetes and complicated diabetes at baseline; and they are more likely to develop worse diabetes in follow up years.

Project Staff

Maine Department of Health and Human Services, Office of Quality Improvement

Elsie Freeman, MD, MPH 


University of Southern Maine,  Muskie School of Public Service

Catherine McGuire

J. William Thomas

Deborah Thayer

Tina Gressani

Mark Rubin

Victoria Abbott

Jennifer MacKenzie