Thresholds: 2007 – 2008

Thresholds member is examined by Thresholds nurse in the new IHC-North clinic.

Founded in 1959, Thresholds is Illinois’ oldest and largest nonprofit psychiatric rehabilitation center, annually serving more than 7,000 people with serious mental illness, with 30 distinct programs at 75 sites throughout the metropolitan Chicago area and the surrounding Kankakee, Lake and McHenry counties. Washington Square Health Foundation started Threshold’s primary care services 20 years ago with a grant for a nurse to provide health care to Threshold’s members, which helped support a program providing general physicals to incoming mental health patients.

Through a recent Program Related Investment from the Washington Square Health Foundation, Thresholds has been able to renovate space and relocate the Integrated Health Care (IHC)-North clinic in the North Center neighborhood.

While previously housed on the third floor of a busy Thresholds program site, with limited space and maneuverability, the IHC-North clinic is now easily accessible at street level, just north of its prior location, with a separate, secure entrance, a private reception area, and several bright, large examination rooms. Open since October 2008, this new space is welcoming members in search of high quality, integrated care, and making it possible for them to receive the necessary attention and support to improve their physical and mental well-being.

Thresholds offers an extensive array of services, including housing, employment, education, psychosocial rehabilitation, and primary physical care, among others, with the goal of providing as many supports and services as desired or needed by the agency’s members – the preferred name for those who use Thresholds’ services – as they work towards recovery and the leading of successful, productive lives.

Recent reports show persons with serious mental illness (SMI) dying 25 years earlier than counterparts in the general population.  This is due largely to treatable medical conditions and modifiable lifestyle factors.  Those with SMI living into their later years have a disproportionately high rate of serious illness, including diabetes, cardiovascular disease, and respiratory disease, several times that of the general population.  Moreover, people with SMI are more likely to seek care while in crisis at noisy public sector clinics or hospitals that are often unwelcoming, and therefore receive health care that is episodic and fragmented, or often avoid all primary health care.

To address these concerns, Thresholds’ Integrated Health Care (IHC) clinics annually serve hundreds of people with severe and persistent mental illness by providing high quality, coordinated primary and mental health care in quiet, safe settings.  Since 1998, in collaboration with the University of Illinois at Chicago College of Nursing (CON) and supported in part by the Washington Square Health Foundation, Thresholds has offered three IHC clinics which are housed in Thresholds facilities and staffed by the CON’s Institute for Healthcare Innovation, including advanced nurse practitioners in mental and primary health care, with their students.  At the clinics, primary and mental health care services are tailored to each individual member’s unique blend of complex needs and challenges.

Because the IHC clinics are located within agency facilities, Thresholds members are notably more comfortable during their visits.  Consequently, they demonstrate a greater likelihood of returning for follow-up appointments, and their general physical health is generally better than that of members who use public sector clinics and emergency rooms for primary health care services, or those who do not seek services at all.  In 2007, in partnership with Mile Square Health Center, the clinics successfully obtained Federally Qualified Health Centers (FQHC) status, a significant, positive step towards financial viability and sustainability.

For more information about Thresholds, please visit To read the Agency for Healthcare Research and Quality’s recent article on the IHC clinics, please click here.