Reengagement of High-Need Individuals with Serious Mental Illness After Discontinuation of Services

Published In: Psychiatric Services, v. 65, no. 11, Nov. 2014, p. 1378-1380

Posted on RAND.org on January 01, 2014

by Thomas E. Smith, Bradley D. Stein, Sheila A. Donahue, Mark J. Sorbero, Adam Karpati, Trish Marsik, Robert W. Myers, Doreen Thomann-Howe, Anita Appel, S. Essock-Vitale

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Research Question

  1. Which individuals needing mental health treatment who have disengaged from treatment can benefit from active provider outreach?

OBJECTIVE: The study determined rates of reengagement in services for individuals with serious mental illness who had discontinued services. METHODS: As part of a quality assurance program in New York City involving continuous review of Medicaid claims and other administrative data, clinician care monitors identified 2,834 individuals with serious mental illness who were apparently in need of care but disengaged from services. The care monitors reviewed monthly updates of Medicaid claims, encouraged outreach from providers who had previously worked with identified individuals, and determined whether individuals had reengaged in services. RESULTS: Reengagement rates over a 12-month follow-up period were low, particularly for individuals who had been incarcerated or for whom no service provider was available to provide outreach. CONCLUSIONS: Subgroups of disengaged individuals with serious mental illness have different rates of reengagement. Active outreach by providers might benefit some, but such targeting is inefficient when the individual cannot be located.

Key Findings

  • Subgroups of individuals who need mental health treatment disengage from treatment at different rates.
  • Administrative data can help identify those who might benefit from outreach.
  • Re-engagement depends on individual characteristics, the nature of provider outreach, and the quality of the relationship between the individual and provider.

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