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Impact of organizational change on the intake, referral and treatment of outpatients at a community mental health center

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Abstract

The authors evaluated two indices of services for 349 outpatients who requested an initial appointment for screening and evaluation at a community mental health center over a one-month period in April of 1981, 1984, and 1988. Intake waiting time after initial screening and evaluation was 15.2 treatment days in 1981, 15.4 treatment days in 1984 and reduced to 2.7 treatment days in 1988. For patients who were referred for continued outpatient treatment, the dropout rates were reduced from 54.3 percent in 1981, to 28.51 percent in 1984 and further reduced to 19.19 percent in 1988.

A divisional structure was designed with the purpose of reducing organizational barriers in order to provide greater access to services and to enhance continuity of care to patients. These results suggest that systematic organizational changes and the implementation of clearly defined clinical and administrative policies and procedures can impact favorably upon the intake, referral and treatment of outpatients.

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References

  1. Mental Health, U.S. United States Department of Health and Human Services, National Institute of Mental Health, 1987.

  2. Noonan RJ: A follow-up of pre-therapy drop outs. Journal of Community Psychology 1973; 1:43–44.

    Google Scholar 

  3. Burgoyne R, Acosta F, Yomamoto J: Telephone prompting to increase attendance at a psychiatric outpatient clinic. American Journal of Psychiatry 1983; 140:345–347.

    CAS  PubMed  Google Scholar 

  4. Bowden CL, Schoenfeld LS, Adams R: A correlation between drop out status improvement in a psychiatric clinic. Hospital and Community Psychiatry 1980; 31:192–195.

    CAS  PubMed  Google Scholar 

  5. Nirenburg T, Sobell L, Sobell M: Effective and inexpensive procedures for decreasing client attrition in an outpatient alcohol treatment program. American Journal of Drug and Alcohol Abuse 1980; 7:73–82.

    Google Scholar 

  6. Last C, Thase M, Hersen M, Bellack A, Himmelhoch J: Patterns of attrition for psychosocial and pharmacologic treatments of depression. Journal of Clinical Psychiatry 1985; 46:361–366.

    CAS  PubMed  Google Scholar 

  7. Foulks E, Persons J, Merkel, L: The effect of patient's beliefs about their illness on compliance in psychotherapy. American Journal of Psychiatry 1986; 143:340–344.

    CAS  PubMed  Google Scholar 

  8. Good M, Hendrickson P: A study of postevaluation change in clinician and treatment dropout rates. Hospital and Community Psychiatry 1986; 37:76–77.

    CAS  PubMed  Google Scholar 

  9. Boswell P, Brauzer B, Postlethwaite N, Laruffa A: Improving aftercare patients' complicance through phone calls and letters. Hospital and Community Psychiatry 1983; 34:358–359.

    CAS  PubMed  Google Scholar 

  10. Pekarik G: Coping with dropouts. Professional Psychology: Research and Practice 1985; 16:114–123.

    Article  Google Scholar 

  11. Carpenter P, Morrow C, Delgaudio A, Ritzer B: Who keeps the first outpatient appointment? American Journal of Psychiatry 1981; 138:1157–1158.

    Google Scholar 

  12. Delgaudio A, Carpenter P, Stein L, Morrow G: Characteristics of patients completing referrals from an emergency department to a psychiatric outpatient clinic. Comprehensive Psychiatry 1977; 18:301–307.

    Article  CAS  Google Scholar 

  13. Chemeides W, Yamamoto J: Referral failures: a one year follow-up. American Journal of Psychiatry 1973; 130:1157–1158.

    Google Scholar 

  14. Chesney A, Brown K, Poe C, Gary H: Physician-patient agreement on symptoms as a predictor of retention in outpatient care. Hospital and Community Psychiatry 1983; 34:737–738.

    CAS  PubMed  Google Scholar 

  15. Robin A: Rationing Outpatients: A Defense of the Waiting List. British Journal of Psychiatry 1976; 128:138–141.

    Article  Google Scholar 

  16. Atwood N, Beck J: Service and patient predictors of continuation in clinic-based treatment. Hospital and Community Psychiatry 1985; 36: 865–869.

    CAS  PubMed  Google Scholar 

  17. Carr C: Telephone prompts to reduce missed CMHC appointments. Hospital and Community Psychiatry 1985; 36:1217–1218.

    CAS  PubMed  Google Scholar 

Download references

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Salta, L., Buick, W.P. Impact of organizational change on the intake, referral and treatment of outpatients at a community mental health center. The Journal of Mental Health Administration 16, 71–79 (1989). https://doi.org/10.1007/BF02521384

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