Engagement-focused care during transitions from inpatient and emergency psychiatric facilities

Dawn I. Velligan, Megan M. Fredrick, Cynthia Sierra, Kiley Hillner, John Kliewer, David L. Roberts, Jim Mintz

Research output: Contribution to journalArticle

Abstract

Objectives: As many as 40% of those with serious mental illness (SMI) do not attend any outpatient visits in the 30 days following discharge. We examined engagement-focused care (EFC) versus treatment as usual in a university-based transitional care clinic (TCC) with a 90-day program serving individuals with SMI discharged from hospitals and emergency rooms. EFC included a unique group intake process (access group) designed to get individuals into care rapidly and a shared decision-making coach. Methods: Assessments of quality of life, symptomatology, and shared decision-making preferences were conducted at baseline, at 3 months corresponding to the end of TCC treatment and 6 months after TCC discharge. Communication among the patients and providers was assessed at each visit as was service utilization during and after TCC. Results: Subjective quality of life improved in EFC. Prescribers and patients saw communication more similarly as time went on. Ninety-one percent of patients wanted at least some say in decisions about their treatment. Conclusions: SDM coaching and improved access improve quality of life. Most people want a say in treatment decisions.

Original languageEnglish (US)
Pages (from-to)919-928
Number of pages10
JournalPatient Preference and Adherence
Volume11
DOIs
StatePublished - May 12 2017

Keywords

  • Community mental health
  • Mental illness
  • Patient education
  • Shared decision making

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Social Sciences (miscellaneous)
  • Pharmacology, Toxicology and Pharmaceutics (miscellaneous)
  • Health Policy

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