Promoting a Clinic-Based Approach to Behavioral Health Integration and Serious Mental Illness in Free and Charitable Clinics Through Project ECHO.

The integration of behavioral health and serious mental illness assessment and treatment into primary care remains a challenge. While the increase in telehealth usage due to the COVID-19 pandemic helped reduce a key barrier to access, other challenges remain including a shortage of trained providers and an increased demand for services. A collaboration between ECHO-Chicago and Americares established a unique virtual medical education program that provided training and telementoring using the Project ECHO model with the integration of clinic-wide quality improvement (QI) projects. In this paper, we outline the process of adapting the existing Project ECHO^® (Extension for Community Health Outcomes) series on behavioral health integration and serious mental illness to fit the needs of Free and Charitable Clinics (FCCs). This project highlights the process and organizational-wide outcomes of creating a partnership between an ECHO hub and a national cross-section of FCCs to create a telehealth program to improve mental healthcare delivery within the FCC space that can be replicated and scaled more broadly. Through this process, we highlight evaluation methods to examine the impact of ECHO series beyond the individual to the clinic-wide level.