Providing Continuity of Care For Mental Illness Patients Beyond Hospital Discharge

A strong family and caregiver support system ismanagement models and chronic care models and
important to the continued treatment of mentalcan include: assertive community treatment,
health patients after they leave the hospital. In fact,multi-systemic therapy, and Dialectical Behavioral
it is critical in assisting with medication adherence toTherapy (DBT). Hospital payment methods assume
ensure consumers appear for their appointments withlinkage with step-down, aftercare, and outpatient
service providers, particularly during transitionservices, similar conceptually to Medicare Part A that
between inpatient and outpatient settings. However,covers hospital stays and 100 days of nursing home
when discussing family support systems, someor home health rehabilitation as follow-up, when
physicians contest that less than half of consumersnecessary.
have an "adequate" social support system to meetLevels of communication between various clinicians
their daily needs.and other staff in inpatient and outpatient settings
Because a strong family support system cannot becan vary greatly, impacting continuity of therapy.
"manufactured" or bought through funding, it isTypically, there is very little communication between
important to focus on other controllable issues thatpsychiatrists in inpatient and outpatient facilities and
can create a positive impact on the continuity of carethis applies as well to nursing staff in these two
for mental illness patients. A recent mental healthsettings. The most frequent communications occur
study identified three factors that positively influencebetween inpatient discharge planners and outpatient
the efficiency of the transition process betweenintake coordinators. Three specific models of
inpatient facility discharge and intake with ainteraction between inpatient and outpatient facilities
community-based program.have been identified:
These include:* "Push" Model: In this model, the outpatient setting is
* when communication occurs "within system"highly dependent on the inpatient setting and/or the
* when computer systems/consumer records areconsumer for receiving documents.
shared* "Integrated" Model: With this model, the sharing of
* when an ACT (or similar) team is involvedresources provides a continuum of care for
Of course, in addition to having a strong family andconsumers, so there is never really a "gap" between
care support, there are other issues involved. Publicdischarge and intake.
policy and government funding are two particularly* "Pull" Model: For this model, a member of the
impactful issues. From a mental healthcare systemsoutpatient treatment team actively participates in the
perspective, matters involving policy and financingdischarge process, which leads to the timely receipt
issues impacting continuity of care can beof appropriate/relevant documents, as well as
conceptualized along two broad approaches:increased consumer participation.
1.) Building service coordination into the paymentDespite the link between positive consumer
rates and expectations for certain services.outcomes and continuity of therapy, it remains
This approach is conceptually similar to what isunclear, in many cases, how referrals are made
referred to as Primary Care Case Management inthroughout the system of care; how hospital and
some disease management or chronic care programs.program admission criteria are developed and applied;
2.) Defining certain consultation and care coordinationhow consumers are discharged from hospital settings
services as covered benefits.and into the community; and who is responsible for
Under the first approach, consultation and caretheir care. Data regarding who is going to hospital
coordination would be a defined benefit with its ownemergency departments for acute psychiatric care
billing codes and defined coverage limits, eligibleand why they are in that setting rather than in
providers, allowed situations, and limitations andcommunity mental health program are scarce, as are
exclusions. For example, situations where this mightdata about individuals who could be moved out of
be applicable include: hospital discharge planning andhospital emergency rooms if consumers were
short-term transition support; developmentalprovided with better transition services or if
transitions (e.g. child to adult); coordination betweenappropriate acute psychiatric care were available in
primary care and mental health providers; consultationother settings. The same observation can be made
with primary care; consultation with otherregarding those individuals who could be moved out
professionals to implement treatment plans (e.g.of state psychiatric hospitals if appropriate services
schools, residential programs); clinical coordinationsuch as care management, medication management,
among multi-disciplinary teams, especially home-basedhousing, and employment supports were available in
services.the community. Obtaining these observations and
Under the second approach, coordination of care isdata of this kind is a big and important step in
built into programs of mental healthcare or episodesensuring a continuity of care for all mental illness
of care. This concept is seen in current diseasepatients.