Trust Is the First Intervention: Lessons from the M3 Team Model

By Dr. Patrick Lee, President & CEO, Central Health

Reimagining Care for Those Too Often Left Out

At Central Health, we often say that care begins with trust. But trust isn’t built in a single visit. It’s built over time, through relationships, consistency, and a deep understanding of the systems that shape people’s lives.

That’s especially true for people experiencing homelessness, who face some of the greatest health risks and structural barriers in our community. When chronic illness, serious mental illness, and substance use disorders intersect with housing insecurity, the result is often a revolving door of emergency rooms, untreated symptoms, and missed opportunities for healing.

We’re building a system designed to respond, not just with services, but with a different way of showing up.

A new peer-reviewed study co-authored by Dr. Tim Mercer, Central Health’s Co-Director of High-Risk Populations and Associate Professor at Dell Medical School, offers a powerful example of what this can look like.

The M3 Team: A Collaborative Model Rooted in Dignity and Integration

The Mobile, Medical, and Mental Health Care (M3) Team is a multidisciplinary, street-based care team serving individuals experiencing chronic homelessness in Travis County. It focuses on people with trimorbidity: the intersection of chronic medical conditions, serious mental illness, and substance use disorders.

The model was originally developed and implemented by three core partners in our local safety-net system:

• CommUnityCare, delivering primary care through its Healthcare for the Homeless program
• Integral Care, providing behavioral health care, substance use treatment, housing support, and peer services
• Dell Medical School, offering leadership, integration support, and evaluation

Today, Central Health supports the model through care coordination, employing a dedicated nurse and medical assistant to help patients navigate across systems.

The study’s findings are compelling:

• A nearly 50% drop in emergency room visits
• Measurable reductions in mental health and substance use symptoms, from moderate to low severity
• A care model rooted in racial equity, trust, and long-term engagement

But the real power of this work isn’t just in the metrics, it’s in the model of care: integrated, patient-centered, and grounded in relationships.

Beyond Conventional Models

Traditional Health Care for the Homeless programs have often focused narrowly on primary care. The M3 Team model goes further, integrating:

• Evidence-based mental health and substance use treatment
• Trauma-informed primary care, adapted to people’s environments
• Housing navigation and social support services
• A patient-centered philosophy, honoring each individual’s readiness and agency

This is care that doesn’t expect people to come to the system, it brings the system to them.

It’s mobile. It’s relational. And it’s built through deep partnership between Central Health, CommUnityCare, Integral Care, and Dell Medical School.

What We’re Applying at Central Health

The M3 Team model is helping shape how we care for people with the most complex needs across our system. Dr. Mercer’s leadership, and the collaboration among our community partners has informed key efforts at Central Health, including:

• Bridge Mobile: Our mobile, low-barrier outreach connecting people experiencing homelessness with integrated, person-centered care
• Housing for Health: An initiative connecting permanent supportive housing with wraparound services
• A broader commitment to equity-centered system design that meets people where they are

This isn’t just about programs, it’s about transformation. One trunk, many branches. One system, built for everyone.

The Deeper Lesson: Trust is the First Intervention

This study affirms what we hear again and again: healing starts with being seen and being met with consistency and compassion.

That kind of care isn’t fast. But it’s how systems change, and how lives change.

We’re grateful to our partners at Dell Med, CommUnityCare, and Integral Care for leading this work, and to Dr. Mercer for showing what it means to build a system that listens, learns, and walks alongside those most often left behind.

📖 Read the study summary: https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-025-12860-0