Date of Award

Fall 2018

Document Type

Open Access Dissertation



First Advisor

Bret Kloos


Introduction: This study examined the relationship between (a) physical health problems among individuals diagnosed with serious mental illness (SMI), (b) their demographic and psychosocial characteristics which may be risk and protective factors for physical health problems, and (c) the use of mental health case management services. Methods: Data collected from community mental health center consumers residing in supported housing (N = 357) included number of self-reported physical health problems and impairment. Services use and billing data were collected on targeted case management (TCM) and mental illness management services (MIMS). Results: Regression models indicated that older individuals, females, those with a mental illness diagnosis of a mood or anxiety disorder, and higher levels psychological distress were more likely to endorse higher numbers of physical health problems. Crosstabs showed that African-American females, older individuals, and those with a diagnosis of a thought disorder were more likely to experience the three most common physical health problems: hypertension, other cardiovascular illnesses, and diabetes. Tests of a moderation model of the relationship between physical health problems, impairment, and service use showed that with an increase in physical health problems, total and MIMS service use increased dependent on having a high level of working alliance. Discussion: Results highlighted subgroups at risk for worse physical health, the importance of working alliance in treatment, and provided information which can be used in screening, prevention, and intervention efforts.