Outpatients in psychiatric rehabilitation valued physical activity, but mental illness symptoms, medication sedation, weight gain, fear of unsafe conditions, fear of discrimination, and interpretations of program compliance were barriers. Confronting how attitudes and barriers specific to this population can affect activity and reframing program compliance to include the independent initiation of activity as part of improving health might help clients of mental health services to become more active.

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Integrated Health Care (IHC) is a nurse-managed center of the College of Nursing, University of Illinois at Chicago through which faculty nurse practitioners and clinical nurse specialists provide primary and mental healthcare services for people with serious mental illness in partnership with Thresholds, the leading freestanding psychiatric rehabilitation agency in Illinois with locations throughout metropolitan Chicago.This article describes a new project to increase access to IHC services and improve health outcomes for the most vulnerable, hard-to-reach Thresholds clients (called members) through an innovative combination of strategies to outreach beyond IHC's three clinic locations, including: house calls, group visits, and telemonitoring, IHC Without Walls (IHC WOW).As an academic nursing practice, we view IHC WOW as an opportunity to integrate teaching and evidence-based practice; accordingly our objectives include expansion of novice and advanced practice experiential learning within this innovative practice domain.

Meeting the needs of patients who experience physical pain and a psychiatric illness presents challenges as well as opportunities to optimize collaborative partnerships between specialty and primary care services. It is imperative that patients with pain be evaluated for depression and those who present with depression be evaluated for pain to prevent chronic opiate overuse. Given the overlap in symptomatology patients can present in either primary care or psychiatric care, an understanding of the comorbid presentation and lived experience of these patients is essential to holistic and complementary care. The current article examines the nature of pain and comorbid depression and anxiety along with suggested treatment modalities that can modify psychological processes and behavior that perpetuate the pain experience and increase need for opiate medication. [Journal of Psychosocial Nursing and Mental Health Services, 56(12), 17-21.].