Caring for previously hospitalized consumers : progress and challenges in mental health system reform : final report to the Joint Legislative Program Evaluation Oversight Committee - Page 15 |
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Mental Health System Services Report No. 2008- 12- 04 Page 11 of 23 option that is easier to pursue than securing community- based services. A lack of adequate crisis services was blamed for overuse of hospitals by another administrator: “ More intensive non- hospital crisis services are needed in order to prevent utilization of inpatient hospitalization.” Finding 3. As expected, consumers discharged from community hospital psychiatric units were more likely to receive services than those returning to the community from a state facility. One assumption of reform was that consumers served in community- based hospitals would achieve better integration into the community and less disruption after discharge. Presumably, closer connections exist between community- based hospitals and local outpatient service providers, and therefore consumers discharged from these hospitals would be more likely to receive community- based services. 13 Consistent with this assumption, most of the consumers ( 69%) discharged from community hospital psychiatric units in 2006 received outpatient services in 2007 ( see Exhibit 6). This level of follow- up was only exceeded among those discharged from private psychiatric hospitals, where 81% of consumers ( all but one of whom were children) received services. There was a significant difference14 in rates of follow- up between state and non- state ( i. e., private and community) hospital facilities: just half ( 50%) of consumers discharged from state psychiatric facilities received follow- up community-based services. Consumers discharged from state Alcohol and Drug Addiction Treatment Centers had the lowest rate of follow- up ( 41%). MHDDSAS administrators suggested treating consumers with substance abuse problems is difficult for several reasons. First, there was a lack of intensive outpatient substance abuse services in 2007, which remains the case today in spite of reform. Second, most consumers with substance abuse do not have Medicaid coverage. As a result, many go untreated after discharge. Third, whereas hospital liaisons triage care for mental health consumers in most Local Management Entities, there are fewer liaisons for consumers hospitalized with substance abuse problems. Finally, many consumers with substance abuse may be noncompliant with treatment protocols even when follow- up is attempted. 13 A map of the location of facility types represented in this evaluation can be found in Appendix A. 14 Pearson χ2 = 1062.80, p < .001.
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Title | Caring for previously hospitalized consumers : progress and challenges in mental health system reform : final report to the Joint Legislative Program Evaluation Oversight Committee - Page 15 |
Full Text | Mental Health System Services Report No. 2008- 12- 04 Page 11 of 23 option that is easier to pursue than securing community- based services. A lack of adequate crisis services was blamed for overuse of hospitals by another administrator: “ More intensive non- hospital crisis services are needed in order to prevent utilization of inpatient hospitalization.” Finding 3. As expected, consumers discharged from community hospital psychiatric units were more likely to receive services than those returning to the community from a state facility. One assumption of reform was that consumers served in community- based hospitals would achieve better integration into the community and less disruption after discharge. Presumably, closer connections exist between community- based hospitals and local outpatient service providers, and therefore consumers discharged from these hospitals would be more likely to receive community- based services. 13 Consistent with this assumption, most of the consumers ( 69%) discharged from community hospital psychiatric units in 2006 received outpatient services in 2007 ( see Exhibit 6). This level of follow- up was only exceeded among those discharged from private psychiatric hospitals, where 81% of consumers ( all but one of whom were children) received services. There was a significant difference14 in rates of follow- up between state and non- state ( i. e., private and community) hospital facilities: just half ( 50%) of consumers discharged from state psychiatric facilities received follow- up community-based services. Consumers discharged from state Alcohol and Drug Addiction Treatment Centers had the lowest rate of follow- up ( 41%). MHDDSAS administrators suggested treating consumers with substance abuse problems is difficult for several reasons. First, there was a lack of intensive outpatient substance abuse services in 2007, which remains the case today in spite of reform. Second, most consumers with substance abuse do not have Medicaid coverage. As a result, many go untreated after discharge. Third, whereas hospital liaisons triage care for mental health consumers in most Local Management Entities, there are fewer liaisons for consumers hospitalized with substance abuse problems. Finally, many consumers with substance abuse may be noncompliant with treatment protocols even when follow- up is attempted. 13 A map of the location of facility types represented in this evaluation can be found in Appendix A. 14 Pearson χ2 = 1062.80, p < .001. |