This work may not be copied, distributed, displayed, published, reproduced, transmitted, modified, posted, sold, licensed, or used for commercial purposes. By downloading this file, you are agreeing to the publisher’s Terms & Conditions. People with severe and persistent mental illnesses, such as schizophrenia, often receive inadequate general medical care1–6 and are documented to have a 25-year shorter lifespan than those without serious mental illness.7–10 Individuals with severe and persistent mental illnesses are frequently stigmatized, are often impoverished, frequently have co-occurring alcohol and/or substance use disorders, and are incarcerated in such large numbers that jails and prisons have become the new mental “institutions.”11–14 Additionally, more than 68% of adults with a mental disorder have at least 1 medical condition,8 resulting in decreased quantity and quality of life, increased symptom burden, and increased health care costs.15–17 Due to the long-standing lack of integration between mental health and primary care services, the “Final Report for the President’s New Freedom Commission on Mental Health”8 recommended use of evidence-based models to improve patient care at the interface of general medicine and mental health. Patients often present to their primary care providers with physical complaints; however, careful evaluation determines that, in many instances, the visit is driven by mental health or substance abuse issues. A Center for Health Care Strategies analysis found that, among Medicaid patients with chronic conditions, a comorbid mental health or substance use disorder predicted 60%–75% higher health care costs compared to those without comorbid mental health or substance use disorders. Further, patients with comorbid mental health or substance use disorders were 4 to 5 times more likely to be hospitalized than those without.16 The Center for Health Care Strategies offered ways to address these patient needs including use of multidisciplinary health care teams for patients with multiple complex needs, integration of behavioral health and physical health care, and financial incentives to care integration.