Factors Influencing Diversion from State Mental Health Hospitals
DOI:
https://doi.org/10.61841/8wteap80Abstract
Objective: While there has been much research on predictors of psychiatric hospitalizations there has been little research on the community resources, supports and processes used to divert a hospital episode. The pur - pose of this study is to address this gap by studying (1) the community resources available as an alternative to state psychiatric hospitalization; and (2) the practices exhibited when determining whether state hospitalization is necessary.
Methods: A mixed methods design was developed. The purpose of the first arm was to assess what non-hos- pital resources were available to mental health centers. The second arm looked at the processes center staff goes through in determining hospitalization or community diversion.
Results: Differences were noted between centers with high and those with low diversion rates. Centers that tended to use the state hospital less had more community diversion resources available, had an agency philo - sophy aimed at diversion, and used processes which included shared decision-making. Further, staff had more experience and established protocols to ensure follow-up services were in place.
Conclusions: Agencies that fostered a philosophy and protocol focusing on community diversion, provided
Objective: While there has been much research on predictors of psychiatric hospitalizations there has been little research on the community resources, supports and processes used to divert a hospital episode. The pur - pose of this study is to address this gap by studying (1) the community resources available as an alternative to state psychiatric hospitalization; and (2) the practices exhibited when determining whether state hospitalization is necessary.
Methods: A mixed methods design was developed. The purpose of the first arm was to assess what non-hos- pital resources were available to mental health centers. The second arm looked at the processes center staff goes through in determining hospitalization or community diversion.
Results: Differences were noted between centers with high and those with low diversion rates. Centers that tended to use the state hospital less had more community diversion resources available, had an agency philo - sophy aimed at diversion, and used processes which included shared decision-making. Further, staff had more experience and established protocols to ensure follow-up services were in place.
Conclusions: Agencies that fostered a philosophy and protocol focusing on community diversion, provided
Objective: While there has been much research on predictors of psychiatric hospitalizations there has been little research on the community resources, supports and processes used to divert a hospital episode. The pur - pose of this study is to address this gap by studying (1) the community resources available as an alternative to state psychiatric hospitalization; and (2) the practices exhibited when determining whether state hospitalization is necessary.
Methods: A mixed methods design was developed. The purpose of the first arm was to assess what non-hos- pital resources were available to mental health centers. The second arm looked at the processes center staff goes through in determining hospitalization or community diversion.
Results: Differences were noted between centers with high and those with low diversion rates. Centers that tended to use the state hospital less had more community diversion resources available, had an agency philo - sophy aimed at diversion, and used processes which included shared decision-making. Further, staff had more experience and established protocols to ensure follow-up services were in place.
Conclusions: Agencies that fostered a philosophy and protocol focusing on community diversion, provided alternative resources for consumers in crisis, and had adequate monitoring and training increased diversion rates and avoided unnecessary hospitalizations
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References
Berg, B. (1995). Qualitative Research Methods for the Social Sciences (2nd ed.). Needham Heights, MA: Simon & Shuster Co..
Fortney, J. C., Xu, S., & Dong, F. (2009). Community-level correlates of hospitalizations for persons with schizophrenia. Psychiatric Services, 60(6), 772-778.
KDADS (2010). Kansas Department of Aging and Disabilities. Topeka, Kansas. Information may be found at: http://csp.k- dads.ks.gov/agency/mh/Documents/GMHSPC/SubcommitteeReports/2010
Klinkenberg, W. D., & Calsyn, R. J. (1996). Predictors of receipt of aftercare and recidivism among persons with severe mental illness: A review. Psychiatric Services, 47, 487–496.
Lang, K., Meyers, J. L., Korn, J. R., Lee, S., Sikirica, M., Crivera, C., Dirani, R., & Menzin, J.(2010). Medication adher- ence and hospitalization among patients with schizophrenia treated with antipsychotics. Psychiatric Services, 61(12), 1239- 1247.
Miles, M. B., & Huberman, A. M. (1994). An expanded sourcebook: Qualitative data analysis (2nd ed.). Thousand Oaks, CA: Sage.
Min, M. O., Biegel, D. E., & Johnson, J. A. (2005). Predictors of psychiatric hospitalization for adults with co-occurring substance and mental disorders as compared to adults with mental illness only. Psychiatric Rehabilitation Journal, 29(2), 114-121.
Moran, P. W., Doerfler, L. A., Sherz, J., & Lish, J. D. (2000). Rehospitalization of psychiatric patients in a managed care environment. Mental Health Services Research, 2(4), 191-199.
NASMHPD, 2005. National Association of State Mental Health Program Directors. Information may be found @: http://www.nasmhpd.org/Publications/ArchivedPublications.aspx
New Freedom Commission on Mental Health, (2003). Achieving the Promise: Transforming Mental Health Care in Amer- ica. Final Report. DHHS Pub. No. SMA-03-3832. Rockville, MD.
Pasic, J., Russo, J., & Roy-Byrne, P. (2005). High utilizers of psychiatric emergency services.Psychiatric Services, 56(6), 678-684.
Pfeiffer, S. L., O’Malley, D. S., & Shott, S. (1996). Factors associated with the outcome of adults treated in psychiatric hospitals: A synthesis of findings. Psychiatric Services, 47, 263– 269.
Russo, J., Roy-Byrne, P., Jaffe, C., Ries, R., Dagadakis, C., & Avery, D. (1997). Psychiatric status, quality of life, and level of care as predictors of outcomes of acute inpatient treatment. Psychiatric Services, 48, 1427–143
Song, L., Biegel, D. E., & Johnson, J. A. (1998). Predictors of Psychiatric Rehospitalization for Persons with Serious and Persistent Mental Illness. Psychiatric Rehabilitation Journal, 22(2), 155-166.
SRS-DBHS, (2007). Kansas Health Policy Authority (KHPA)-Social and Rehabilitative Services, Disability and Behavior- al Health Services (SRS-DBHS). Topeka, Kansas.
Sullivan, G., Wells, K. B., Morgenstern, H., & Leake, B. (1995). Identifying modifiable risk factors for rehospitalization: A case-control study of seriously mentally ill persons in Mississippi. American Journal of Psychiatry, 152, 1749–175.
TAC (2012). Treatment Advocacy Center. Information may be found at: http://www.treatmentadvocacycenter.org/storage/documents/State
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