VUSN receives nearly $1 million grant to add mental and behavioral health providers to community clinic

Social worker Jenna Pemberton, LMSW, (right) talks with a client at the Clinic at Mercury Courts, which has used a new HRSA grant to add social work and mental health providers. Photo by Anne Rayner.

The Clinic at Mercury Courts has added psychiatric-mental health care to its primary care clinical services, thanks to a $999,101 grant from the U.S. Health and Human Services Administration (HRSA) to Vanderbilt University School of Nursing. The two-year grant allows the nurse-managed clinic to add a psychiatric-mental health nurse practitioner, social worker and psychiatrist to its existing primary care team.

The Mercury Courts clinic opened five years ago as clinical outreach by the Vanderbilt University School of Nursing (VUSN). It operates in one of Nashville’s most economically depressed areas and serves homeless, recently homeless and low-income patients.

The clinic was the brainchild of Professor of Nursing Emerita Bonnie Pilon, PhD, NEA-BC, FAAN, who obtained HRSA funding to establish the clinic. She is also the principal investigator on the new federal grant.

“The new project’s patient goals are to add and incorporate mental health services into primary care at the Mercury Courts clinic,” Pilon said. “By providing integrated care, we hope to reduce emergency department visits and hospitalizations and provide one convenient site for behavioral health and primary care. On the education, practice and quality side, our objectives include long-term sustainability of the behavioral and primary care model and successful integration of health professions trainees into the clinical work flow.”

The Clinic at Mercury Courts operates with an interprofessional, nurse-led, team-based model integrating nursing, pharmacy, social work and medicine. It draws providers from Vanderbilt University Medical Center, Vanderbilt University School of Medicine, VUSN, Lipscomb University and Trevecca Nazarene University.

It also serves as a clinical site for nursing, medical, pharmacy, social work and physician assistant students from those schools, and others, including Tennessee State University, University of Tennessee, and Vanderbilt’s College of Arts and Science, Owen Graduate School of Management, Peabody College and Schools of Divinity and Law. Adding behavioral care allows VUSN’s psychiatric-mental health nurse practitioner students to participate in the trainee groups that rotate through the clinic.

The Clinic at Mercury Courts accepts all patients regardless of ability to pay for services. Approximately 90 percent of its patients live below 200 percent of federal poverty guidelines and 70 percent live in public housing. More than 30 percent are either homeless or have experienced homelessness within the past 12 months. The majority of patients do not have health insurance; many who do struggle to afford premiums, co-pays and deductibles.

Since 2012, the clinic’s interdisciplinary practitioners have seen notable changes in the health of its patient population. From 2012–2016, the clinic improved blood pressure control in patients with hypertension from 18 to 61 percent, increased the number of patients with established self-management goals for their chronic disease (diabetes, hypertension or heart disease) by 82 percent, and improved blood glucose control in diabetic patients from 15 to 30 percent. It sees approximately 900 patients a year and trains more than 30 interprofessional students annually.

The Behavioral Health-Primary Care Integration: The Mercury Courts Model initiative is funded by Nurse Education, Practice, Quality and Retention — Interprofessional Collaborative Practice project UD7HP30932 of the HRSA Bureau of Health Workforce.