Original Paper

Psychiatric Quarterly

, Volume 78, Issue 4, pp 279-286

Reinstitutionalization Following Psychiatric Discharge among VA Patients with Serious Mental Illness: A National Longitudinal Study

  • Cheryl IrmiterAffiliated withDepartment of Psychiatry, Mental Health Services, Outcomes, and Translation Section, University of Michigan Email author 
  • , John F. McCarthyAffiliated withDepartment of Psychiatry, Mental Health Services, Outcomes, and Translation Section, University of MichiganDepartment of Veterans Affairs, Health Services Research and Development Serious Mental Illness Treatment Research and Evaluation Center
  • , Kristen L. BarryAffiliated withDepartment of Psychiatry, Mental Health Services, Outcomes, and Translation Section, University of MichiganDepartment of Veterans Affairs, Health Services Research and Development Serious Mental Illness Treatment Research and Evaluation Center
  • , Soheil SolimanAffiliated withDepartment of Veterans Affairs, Health Services Research and Development Serious Mental Illness Treatment Research and Evaluation Center
  • , Frederic C. BlowAffiliated withDepartment of Psychiatry, Mental Health Services, Outcomes, and Translation Section, University of MichiganDepartment of Veterans Affairs, Health Services Research and Development Serious Mental Illness Treatment Research and Evaluation Center

Rent the article at a discount

Rent now

* Final gross prices may vary according to local VAT.

Get Access

Abstract

Patterns of reinstitutionalization following psychiatric hospitalization for individuals with serious mental illnesses (SMI) vary by medical and psychiatric health care settings. This report presents rates of reinstitutionalization across care settings for 35,527 patients following psychiatric discharge in the Department of Veterans Affairs (VA) health system, a national health care system. Over a 7-year follow-up period, 30,417 patients (86%) were reinstitutionalized. Among these patients, 73% were initially reinstitutionalized to inpatient psychiatric settings. Homelessness, medical morbidity, and substance use were associated with increased risks for reinstitutionalization. Despite the VA’s increased emphasis on outpatient services delivery, the vast majority of patients experienced reinstitutionalization in the follow-up period. Study findings may inform efforts to refine psychiatric and medical assessment for service delivery for this vulnerable population.

Keywords

Psychiatric rehospitalization Reinstitutionalization Serious mental illness Health care systems Co-morbid medical illnesses Dual diagnosis