Psychiatric Quarterly

, Volume 78, Issue 4, pp 279–286 | Cite as

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

  • Cheryl Irmiter
  • John F. McCarthy
  • Kristen L. Barry
  • Soheil Soliman
  • Frederic C. Blow
Original Paper

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 

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Copyright information

© Springer Science+Business Media, LLC 2007

Authors and Affiliations

  • Cheryl Irmiter
    • 1
  • John F. McCarthy
    • 1
    • 2
  • Kristen L. Barry
    • 1
    • 2
  • Soheil Soliman
    • 2
  • Frederic C. Blow
    • 1
    • 2
  1. 1.Department of Psychiatry, Mental Health Services, Outcomes, and Translation SectionUniversity of MichiganAnn ArborUSA
  2. 2.Department of Veterans AffairsHealth Services Research and Development Serious Mental Illness Treatment Research and Evaluation CenterAnn ArborUSA

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