Hepatitis C Screening Rate Among Underserved Adults With Serious Mental Illness Receiving Care in California Community Mental Health Centers

Although HCV is more prevalent among people with severe mental illness (SMI; e.g., schizophrenia, bipolar disorder) than in the general population (17% vs 1%), no large previous studies have examined HCV screening in this population. In this cross-sectional study, we examined administrative data for 57 170 California Medicaid enrollees with SMI to identify prevalence and predictors of HCV screening from October 2010 through September 2011. Only 4.7% (2674 of 57 170) received HCV screening, with strongest predictors being nonpsychiatric health care utilization and comorbid substance abuse.People with severe mental illness (SMI; e.g., schizophrenia, bipolar disorder) die 25 years earlier than the general population.1 Although cardiovascular disease represents the primary cause of mortality,1 blood-borne infectious diseases are another contributor.2 HCV is the most prevalent blood-borne infection in the United States; by the best available estimates, more than 17% of people with SMI have HCV, compared with only 1% of the general US population.2 Although prevention, early detection, and treatment are crucial interventions for high-risk populations, most people with SMI do not receive these services.3 To our knowledge, no previous large studies have examined HCV testing among this high-risk population served in the public mental health system.4