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The Prediction of Mental Health Service Use in Residential Care

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Abstract

The purpose of this study was to characterize the clinical and psychosocial factors of residents living in psychiatric nursing homes, assess residents' levels of mental health service utilization, and examine the factors that predict the utilization of mental health services. Data were collected from 200 randomly selected residents with schizophrenia living in four intermediate care facilities. Fewer than 60% of residents received mental health services beyond medication and nearly one-half of the residents were readmitted to the hospital in the course of a year. Family contact and involvement in activities were associated with mental health service utilization. Hospital readmission was predicted, not by substance use, but rather by not using substances. There is a growing need among service providers to better identify relevant factors that are important in treatment planning and service delivery. Attention to these issues may impact treatment provision and outcomes for persons with schizophrenia and their families.

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References

  • Albert, M., Becker, T., McCrone, P., & Thornicroft, G. (1998). Social networks and mental health service utilisation—a literature review. International Journal of Social Psychiatry, 44(4), 248–266.

    Google Scholar 

  • American Psychiatric Association. (1994). Diagnostic and Statistical Manual of Mental Disorders (4th ed.). Washington, DC: American Psychiatric Association.

    Google Scholar 

  • Anderson, R.L., & Lewis, D.A. (1999). Clinical characteristics and service use of persons with mental illness living in an intermediate care facility. Psychiatric Services, 50, 1341–1345.

    Google Scholar 

  • Anderson, R.L., & Lyons, J.S. (in press). Needs-based planning for persons with serious mental illness residing in intermediate care facilities. The Journal of Behavioral Health Services & Research.

  • Bartels, S.J., Teague, G.B., Drake, R.E., Clark, R.E., Bush, P.W., & Noordsy, D.L. (1993). Substance abuse in schizophrenia: Service utilization and costs. The Journal of Nervous and Mental Disease, 181, 227–232.

    Google Scholar 

  • Blass, J. P. (1985). Mental status tests in geriatrics. Journal of the American Geriatric Society, 33, 461–462.

    Google Scholar 

  • Blow, F.C., Barry, K.L., BootsMiller, B.J., Copeland, L.A., McCormick, R., & Visnic, S. (1998). Longitudinal assessment of inpatient use and functioning of seriously mentally ill veterans with and without co-occurring substance use disorders. Journal of Psychiatric Research, 32, 311–319.

    Google Scholar 

  • Bootzin, R.R., Shadish, W.R., & McSweeny, A.J. (1989). Longitudinal outcomes of nursing home care for severely mentally ill patients. Journal of Social Issues, 45, 31–48.

    Google Scholar 

  • Borson, S., Liptzin, B., Nininger, J., & Rabins, P. (1987). Psychiatry and the nursing home. American Journal of Psychiatry, 144, 1412–1418.

    Google Scholar 

  • Grob, G.N. (1991). From Asylum to Community. Mental Health Policy in Modern America. Princeton, NJ: Princeton University Press.

    Google Scholar 

  • Heyscue, B.E., Levin, G.M., & Merrick, J.P. (1998). Compliance with depot antipsychotic medication by patients attending outpatient clinics. Psychiatric Services, 49(9), 1232–1234.

    Google Scholar 

  • Howard, K.I., Kopta, S.M., Krause, M.S., & Orlinsky, D.E. (1986). The dose-effect relationship in psychotherapy. American Psychologist, 41, 159–164.

    Google Scholar 

  • Howard, K.I., Martinovich, Z., & Black, M. (1997). Outpatient outcomes. Psychiatric Annals, 27(2), 108–112.

    Google Scholar 

  • Lehman, A.F., & Steinwachs, D.M. (1998). Patterns of usual care for schizophrenia: Initial results from the Schizophrenia Patient Outcomes Research Team (PORT) Client Survey. Schizophrenia Bulletin, 24, 11–20.

    Google Scholar 

  • Lyons, J. S., Howard, K.I., O'Mahoney, M.T., & Lish, J. (1997). The measurement and management of clinical outcomes in mental health. New York: John Wiley and Sons.

    Google Scholar 

  • Lyons, J. S., O'Mahoney, M.T., Doheny, K. M., Dworkin, L.N., & Miller, S.I. (1995). The prediction of short-stay psychiatric inpatients. Administration and Policy in Mental Health, 23, 17–25.

    Google Scholar 

  • Mahoney, F.I., & Barthel, D.W. (1965). Functional evaluation: The Barthel Index. Maryland State Medical Journal, 14, 61–65.

    Google Scholar 

  • Maynard, C., & Cox, G.B. (1998). Psychiatric Hospitalization of persons with dual diagnoses: Estimates from two national samples. Psychiatric Services, 49(12), 1615–1617.

    Google Scholar 

  • Mechanic, D. (1986). The challenge of chronic mental illness: A retrospective and prospective view. Hospital and Community Psychiatry, 37, 891–896.

    Google Scholar 

  • Mechanic, D., & Aiken, L.H. (1987). Improving the care of patients with chronic mental illness. The New England Journal of Medicine, 317, 1634–1638.

    Google Scholar 

  • Mitchell, M.E. (1989). The relationship between social network variables and the utilization of mental health services. Journal of Community Psychology, 17, 258–266.

    Google Scholar 

  • Mueser, K.T., Yarnold, P.R., Levinson, D.F., Singh, H., Bellack, A.S., & Kee, K. (1990). Prevalence of substance abuse in schizophrenia: Demographic and clinical correlates. Schizophrenia Bulletin, 16(1), 31–56.

    Google Scholar 

  • Olfson, M., Mechanic, D., Hansell, S., Boyer, C.A., Walkup, J., & Weiden, P.J. (2000). Predicting medication noncompliance after hospital discharge among patients with schizophrenia. Psychiatric Services, 51(2), 216–222.

    Google Scholar 

  • Richardson, M. (1988). Mental health services: Growth and development of a system. In S. J. Williams and P. R. Torrens (Eds.), Introduction to health services (pp. 255–278). New York: John Wiley and Sons.

    Google Scholar 

  • Shadish, W.R., Silber, B.G., & Bootzin, R.R. (1984). Mental patients in nursing homes: Their characteristics and treatment. International Journal of Partial Hospitalization, 2, 153–163.

    Google Scholar 

  • Shea, D.G., Streit, A., & Smyer, M.A. (1994). Determinants of the use of specialist mental health services by nursing home residents. Health Services Research, 29, 169–185.

    Google Scholar 

  • Sherbourne, C.D. (1988). The role of social support and life stress events in use of mental health services. Social Science and Medicine, 27(12), 1393–1400.

    Google Scholar 

  • Sperry, L., Brill, P., Howard, K.I., & Grissom, G. (1996). Treatment outcomes in psychotherapy and psychiatric interventions. New York: Brunner/Mazel.

    Google Scholar 

  • U.S. Department of Health and Human Services. (1999). Mental Health: A Report of the Surgeon General. Rockville, MD: U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services, National Institutes for Health, National Institute of Mental Health.

    Google Scholar 

  • Vogel, S., & Huguelet, P. (1997). Factors associated with multiple admissions to a public psychiatric hospital. Acta Psychiatrica Scandinavica, 95, 244–253.

    Google Scholar 

  • Ware, J. E., Kosinski, M., Bayliss, M.S., McHorney, C.A., Rogers, W.H., & Raczek, A. (1995). Comparison of methods for the scoring and statistical analysis of SF-36 Health Profile and summary measures: Summary of results from the Medical Outcomes Study. Medical Care, 33, 264–279.

    Google Scholar 

  • Warner, R., Taylor, D., Wright, J., Sloat, A., Springett, G., & Arnold, S. (1994). Substance use among the mentally ill: Prevalence, reasons for use, and effects on illness. American Journal of Orthopsychiatry, 64(1), 30–39.

    Google Scholar 

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Anderson, R.L., Lyons, J.S. & West, C. The Prediction of Mental Health Service Use in Residential Care. Community Ment Health J 37, 313–322 (2001). https://doi.org/10.1023/A:1017548507608

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