Continuity of Care and Client Outcomes in the Robert Wood Johnson Foundation Program on Chronic Mental Illness

The impact on services and outcomes of the local mental health authorities (LMHAs) developed under the RWJF Program on Chronic Mental Illness (CMI) was evaluated in Baltimore, Cincinnati, Columbus, and Toledo. Two cohorts of clients with CMI discharged from an episode of acute 24-hour care were recr...

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Bibliographic Details
Published in:The Milbank quarterly 1994-01, Vol.72 (1), p.105-122
Main Authors: Lehman, Anthony F., Postrado, Leticia T., Roth, Dee, McNary, Scot W., Goldman, Howard H.
Format: Article
Language:English
Subjects:
Baltimore, Maryland
Chronic Disease - economics
Chronic Illness
Chronically
Cohort Studies
Community Mental Health
Community mental health services
Community Mental Health Services - economics
Community Mental Health Services - organization & administration
Continuing care
Continuity of Patient Care - organization & administration
Continuity of Patient Care - statistics & numerical data
Delivery Systems
Female
Financing, Organized
Foundations
Health care
Health outcomes
Hospitalization
Humans
Male
Medical case management
Medical schools
Mental disorders
Mental Disorders - economics
Mental Disorders - therapy
Mental health
Mental health outcomes
Mental health services
Mental Illness
Mentally ill people
Ohio
Patient Care Planning - organization & administration
Program Evaluation
Providing Treatment to Persons with Mental Illness
Psychiatric hospitals
Schizophrenia
Social Programs
Treatment Outcome
Treatment Outcomes
United States
USA
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Description
Summary:The impact on services and outcomes of the local mental health authorities (LMHAs) developed under the RWJF Program on Chronic Mental Illness (CMI) was evaluated in Baltimore, Cincinnati, Columbus, and Toledo. Two cohorts of clients with CMI discharged from an episode of acute 24-hour care were recruited in each city: the first cohorts were drawn shortly after the demonstration began and the second, two years later. The LMHAs in the three Ohio cities increased case management for the second cohorts at two months, but not at 12 months, after hospital discharge. The second cohorts in Baltimore and Cincinnati experienced lower turnover among case managers during the year after discharge, but there was no significant improvement in client outcomes. Creation of LMHAs may be a necessary, but not sufficient, step toward improving outcomes and should be followed by improvement in the quantity and quality of services.
ISSN:0887-378X
1468-0009
DOI:10.2307/3350340