Abstract
Individuals with severe mental illness are at particularly high risk of adverse outcomes such as rehospitalization, homelessness, or harm to self or others, when they are not connected to hospital resources after discharge. In order to drastically reduce the risk of such adverse outcomes, continued emotional and practical support is crucial during the transition from hospital to community. Current collaborative care models do not provide consistent care to address these issues. This paper discusses a collaborative care model involving a tertiary mental health hospital and a community mental health service agency within Durham Region of Ontario, Canada. The CREATE program supports individuals from hospitalization to greater independence, by leveraging empirically supported treatment targets and a client-centered approach. A prospective cohort study was conducted, analyzing program components to determine the impact of CREATE on client outcomes. Clients were assessed on the following parameters: rehospitalizations, level of care, perceived need, and life skills. Results revealed that clients reported greater confidence in various life skills at the end of the program relative to the program's outset. Half of the clients who completed the program achieved independent housing with case management support, while others moved to a more suitable level of care such as a group home, home for special care, or rehospitalization. While more work needs to be done to identify the nuances of what makes the program successful, the promising results from this evaluation can help encourage other communities/agencies to implement similar models of care.
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This study was conducted as a quality improvement project for the CREATE program, thus institutional Research Ethics Board approval was waived.
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O’Connell, J., Magurno, A., Wagner, F. et al. Preparing for Independent Living Following Psychiatric Hospitalization. J. Psychosoc. Rehabil. Ment. Health (2023). https://doi.org/10.1007/s40737-023-00351-6
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DOI: https://doi.org/10.1007/s40737-023-00351-6