Fewer Than Half of Adults Hospitalized with Serious Mental Illness Saw a Primary Care Provider in the Past Year

Adults hospitalized with serious mental illness face disproportionately high rates of chronic medical disease and premature mortality, which makes engagement with primary care an essential part of their overall health care. Yet a new retrospective chart review suggests that even when a primary care provider is formally identified for these patients, actual contact with that provider is often limited.

Researchers examined the records of 278 adults admitted to an inpatient psychiatric unit with major depressive disorder, bipolar disorder, schizophrenia, or schizoaffective disorder. The study looked at three questions: how many patients had an identified primary care provider, how many had actually used primary care in the twelve months before hospitalization, and which demographic and clinical characteristics were associated with that engagement.

Overall, 64.4 percent of patients had an identified primary care provider. However, only 45.3 percent of those patients had attended a primary care visit within the preceding year. In other words, despite nearly two-thirds of hospitalized adults with serious mental illness having a provider on record, fewer than half had engaged with primary care in the year before their admission.

The analysis also identified characteristics linked to having a primary care provider. Patients with an identified provider were older (p=.033), more likely to be female (p=.009), and had more medical conditions treated during their hospitalization (p=.010). These associations suggest that primary care identification in this population clusters around patients with greater age and a larger burden of treated medical conditions.

Housing status also appeared relevant. Unhoused patients were less likely than housed patients to have an identified primary care provider, at 55.7 percent versus 69.0 percent, although the difference did not reach statistical significance (p=.056). The authors note this finding should be interpreted with caution given that it fell short of the conventional threshold for significance.

The presence of a primary care provider on record is frequently used as a marker of healthcare access, but the study raises questions about whether that marker accurately reflects meaningful engagement. The authors state that it remains unclear whether an identified provider corresponds to actual, sustained primary care use, and their utilization data indicate that many patients with a provider on record had not seen that provider in the past year.

Because the study is a retrospective chart review of patients at a single inpatient psychiatric unit, its findings describe the records of the 278 adults studied rather than establishing causal relationships. The authors emphasize that further research is needed to characterize the quality and continuity of primary care in this population and to determine the impact of meaningful primary care engagement among hospitalized patients with serious mental illness.

For clinicians and health systems, the results suggest that simply recording a primary care provider may not be sufficient to ensure that patients hospitalized with serious mental illness are receiving the ongoing medical care that their elevated rates of chronic disease and premature mortality would call for.

Subject of Research: Primary care engagement among adults hospitalized with serious mental illness

Article Title: Primary Care Engagement Among Adults Hospitalized with Serious Mental Illness

Article References: Reddy, Y., Fountain, S., Numbers, S., Ketteler, S., Wang, L., Schneiderhan, A., & Dhatreecharan, G. (2026). Primary Care Engagement Among Adults Hospitalized with Serious Mental Illness. Community Mental Health Journal. https://doi.org/10.1007/s10597-026-01743-1

Image Credits: AI Generated

DOI: 10.1007/s10597-026-01743-1

Keywords: serious mental illness, primary care, psychiatric hospitalization, retrospective chart review, healthcare access, schizophrenia, bipolar disorder, major depressive disorder, housing status, chronic disease, Primary, Care