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North Staffordshire Community Beds Study: longitudinal evaluation of psychiatric in-patient units attached to community mental health centres I: Methods, outcome and patient satisfaction

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BRITISH JOURNAL OF PSYCHIATRY 1999年第1期175卷 70-78页

作者： Boardman, AP Hodgson, RE Lewis, M Allen, K Kings Coll Hosp Acad Dept Psychiat Sch Med & Dent London England St Thomas Hosp Sch Med & Dent Acad Dept Psychiat London England Keele Univ Postgrad Med Sch Acad Dept Psychiat Keele Staffs England Guys Hosp Acad Dept Psychiat London SE1 9RT England

Background This study evaluates two in-patient units attached to community mental health centres (CMHCs) that were designed to supplement acute in-patient care and to integrate with community-based after-care services. Aim To examine the comparative outcome of patients with severe mental illness (SMI) admitted to the two units. Method All patients with SMI admitted to the acute psychiatric wards serving the two CMHCs, those transferred to the community in-patient units and those admitted directly to these units (n=110) were compared with patients (n=67) admitted to acute wards serving two similar catchment areas without associated community beds. Baseline clinical and social measures were made and repeated at six and 12 months. Satisfaction with services was assessed at 12 months. Results The experimental group showed significantly better outcomes, significant reduction in unmet need and better satisfaction with services. Conclusions The use of the community beds appears to have significant benefits for patients with SMI. Declaration of interest Support received from the North Staffordshire Health Authority and the North Staffordshire Combined Health Care NHS Trust.

关键词：社区精神卫生服务/利用英格兰医院专科病房住院医院精神病纵向研究精神障碍/治疗结果评价(卫生保健) 病人满意度精神病状态评定量表生活质量成年人女(雌)性人类男(雄)性中年人

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RESIDENTIAL AND COMMUNITY TREATMENT SERVICES UTILIZED BY A SAMPLE OF YOUTH WITH SEVERE EMOTIONAL DISTURBANCES

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AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 1992年第6期20卷 799-809页

作者： JULIAN, DA JULIAN, TW MASTRINE, BJ WESSA, P ATKINSON, E UNITED WAY FRANKLIN CITY COLUMBUSOH OHIO STATE UNIV DEPT FAMILY & COMMUNITYCOLUMBUSOH 43210 DAVON GRP COLUMBUSOH

Analyzed case records to determine the costs and service usage patterns for a group of 25 youth randomly selected from the case load of a regional mental health agency. Study participants had extensive histories of publicly supported psychiatric hospitalizations. An average of 36.2 contacts per youth (905 total contacts) with human services providers were documented. Approximately 2 out of every 5 contacts resulted in out-of-home placements. The estimated cost of providing services to the 25 youth exceeded 3 million dollars. The types and costs of treatment services provided to study participants are discussed.

关键词：情感症状/流行病学情感症状/心理学情感症状/治疗社区精神卫生服务/经济学社区精神卫生服务/利用综合保健/经济学综合保健/利用费用效益分析横断面研究住院/经济学住院/统计学和数值数据发病率俄亥俄/流行病学病人医疗小组/经济学病人医疗小组/统计学和数值数据寄托治疗/经济学寄托治疗/统计学和数值数据青少年女(雌)性人类男(雄)性

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Implementing capitation of Medicaid mental health services in Colorado: Is "readiness" a necessary condition?

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JOURNAL OF BEHAVIORAL HEALTH SERVICES & RESEARCH 2000年第4期27卷 437-445页

作者： Bloom, JR Devers, K Wallace, NT Wilson, N Univ Calif Berkeley Berkeley CA 94720 USA Portland State Univ Mark Hatfield Sch Publ Policy Portland OR 97207 USA

Two consortia of community mental health centers in Colorado varied in their administrative readiness for changing to a capitated system and, ultimately, implemented capitation using different organizational arrangements. The objective was to assess the impact of this natural experiment on administrative change, costs, and utilization of services during the first two years postcapitation. prior to capitation, one was rated as having greater "readiness" than the other and received a capitation contract from the state, while the other did not. A private, for-profit managed behavioral health organization was awarded a contract and formed a joint venture with the less "ready" consortium, providing managed care expertise to complement the consortium's expertise in delivering mental health services. Two years later these consortia do not look different either administratively or in their patterns of service utilization and costs. These findings suggest alternative ways of successfully implementing a capitated public mental health system.

关键词：按人收费科罗拉多社区精神卫生服务/经济学社区精神卫生服务/组织和管理社区精神卫生服务/利用费用效益分析管理医疗规划/组织和管理 Medicaid 模型组织管理地区医疗规划/组织和管理美国利用情况审核人类

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THE VALIDITY OF ASSESSING MENTAL-HEALTH NEEDS WITH SOCIAL-INDICATORS

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EVALUATION AND PROGRAM PLANNING 1986年第2期9卷 127-142页

作者： CAGLE, LT BANKS, SM NEW YORK STATE OFF MENTAL HLTH BUR PLANNING & EVALUAT RES44 HOLLAND AVEALBANYNY 12229 USA

Selection of the appropriate number and types of social indicators for use in mental health planning has been a perennial problem. Social indicators have been associated with several concepts (quality of life, community disorganization, populations at risk) of varying relevance for planning mental health services, and abstracting social indicators from these conceptual domains poses a variety of validity issues. The issues are discussed, and the viability of social indicators in mental health planning is reexamined.

关键词：卫生服务范围社区精神卫生服务/利用人口统计学流行病学方法卫生服务需求/方法卫生服务研究/方法生活质量社会经济因素美国

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The impact of case management on utilization of community support services in a rural state

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ADMINISTRATION AND POLICY IN MENTAL HEALTH 1998年第2期26卷 125-135页

作者： Rohland, BM Rohrer, JE Etsey, YK Univ Iowa Coll Med Psychiat Res MEB Iowa City IA 52242 USA

The authors report on a study testing the hypothesis that persons with serious mental illness (SMI) would report more utilization of community support services if they had a case manager. Individuals with SMI were asked to complete a survey reporting their use of 10 community support services and case management Having a case manager was not associated with increased utilization of any support service or case management by persons with serious mental illness in this rural state.

关键词：病例管理/组织和管理社区精神卫生服务/利用卫生保健调查衣阿华精神障碍/心理学精神障碍/治疗方案评价问卷调查乡村卫生服务/利用成年人老年人老年人 80以上女(雌)性人类男(雄)性中年人

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USE OF SERVICES FOR THE MENTALLY-RETARDED IN THE AFRICAN-AMERICAN COMMUNITY

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JOURNAL OF COMMUNITY PSYCHOLOGY 1981年第1期9卷 45-52页

作者： KERNAN, KT WALKER, MW UNIV CALIF LOS ANGELES LOS ANGELESCA 90024 CALIF STATE UNIV LONG BEACH LONG BEACHCA 90840

Mentally retarded individuals, their families, and professionals in the service delivery system in the African-American community were interviewed concerning the use of services for the mentally retarded. It was found that African-Americans underutilized available services. Reasons for this included aspects of the service delivery system and features of African-American Culture. Recommendations were made for increasing the use of services.

关键词：非洲裔美国人加利福尼亚社区精神卫生服务/利用用户满意精神发育迟滞/康复人类

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Service components of case management which reduce inpatient care use for persons with serious mental illness

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COMMUNITY MENTAL HEALTH JOURNAL 1999年第2期35卷 153-167页

作者： Kuno, E Rothbard, AB Sands, RG Univ Penn Sch Social Work Philadelphia PA 19104 USA

This is a study of two types of case management: case management (CIM) which provided the service coordination functions, and Intensive Case Management (ICM) which consisted of both the coordination function and the provision of direct support to the client. Using secondary data on public clients, characteristics of mental health service use were analyzed for 80 ICM and 84 CM clients. The ICM clients had significantly fewer episodes per patient and less inpatient days per year than the CM clients. These findings suggest that direct support services make a significant difference in reducing annual hospital care.

关键词：病例管理/统计学和数值数据慢性病社区精神卫生服务/利用卫生服务易得程度/统计学和数值数据情绪障碍/流行病学情绪障碍/康复病人再入院/统计学和数值数据费城精神分裂症/流行病学精神分裂症/康复市区人口利用情况审核青少年成年人女(雌)性人类男(雄)性中年人

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TRAINING COMMUNITY-BASED, ASIAN-AMERICAN MENTAL-HEALTH PERSONNEL IN BEHAVIOR-MODIFICATION

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JOURNAL OF COMMUNITY PSYCHOLOGY 1983年第3期11卷 253-258页

作者： STUMPHAUZER, JS DAVIS, LC US DEPT EDUC WASHINGTONDC

AbstractSixteen Asian‐American and Pacific Island mental health professionals received 10 weekly, 2‐hour training sessions on behavior modification and its application, in particular, to Asian‐American clients. A three‐fold assessment of the training results revealed: a) a significant increase in knowledge of behavior modification principles, b) a significant increase in ability to accomplish a behavioral analysis and behavioral treatment plan, and c) a significant increase in one of three attitudes toward behavior modification: oriented activity. In general, the training was rated highly and, perhaps more importantly, was viewed as having relevance for this particular minority population which often underutilizes mental health services. The training model and needs for further consultation and supervision were di

关键词：亚裔美国人行为疗法/教育加利福尼亚社区精神卫生服务/利用卫生职业/教育

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On treating the insane in sane places

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Journal of Community Psychology 1977年第4期5卷 380-387页

作者： Polak, Paul R. Deever, Stan Kirby, Michael W. Southwest Denver Community Mental Health Services Inc United States

Five major issues raised by Rosenhan (1973) about psychiatric hospitals are addressed. For each issue, a resolution is presented and the method of implementing the resolution in the Southwest Denver inpatient hospital alternative system is described. In this system, clinical staff offices have been eliminated;the salience of psychiatric diagnosis has been diminished;it is assumed that, sane or insane, no client needs inpatient admission until proven otherwise. When admission is indicated, a comprehensive range of alternative settings is available, including a network of private homes which contract with the Center to provide room, board, and informal care for clients admitted. The results of a longitudinal research study designed to assess the viability of the private home as an alternative to hospitalization are presented, particularly as they bear on the negative effects of hospitalization as described by Rosenhan. Copyright © 1977 Wiley Periodicals, Inc., A Wiley Company

关键词：科罗拉多社区精神卫生服务/利用人格解体医院精神病/发展趋势纵向研究精神障碍/诊断病人参与人类

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SYSTEM SERVICE PROVISION AND CLIENT SERVICE UTILIZATION IN PUBLIC-SECTOR, HUMAN-SERVICE ORGANIZATIONS

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JOURNAL OF COMMUNITY PSYCHOLOGY 1984年第1期12卷 21-30页

作者： PERLMAN, B DOBBIN, DDF University of Wisconsin—Oshkosh Unified Board—Outagamie County

Service provision and client utilization at the catchment area level were studied to provide data relevant to (a) comprehensiveness of care, (b) client behavior with human service organizations, and (c) management and policy in times of fiscal decline and/or scarcity. Four human service organizations and 3529 clients seen over a six-month period were sampled. At the system level, data revealed a 100% duplication rate by the four organizations for nine service categories. At the individual level, 7% (n = 250) of the clients were multiorganization users and of these, only 150 received duplicated services. Implications of these data for comprehensiveness of care, utilization and provision duplication, human service system impetus and future research were discussed. Overcomprehensiveness of service provision may be a problem. At the client level, more research on differences between the multiorganization user who does and does not receive duplicated services is needed.

关键词：卫生服务范围社区精神卫生服务/利用综合保健卫生服务需求卫生服务研究威斯康星

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