Transitions between health care systems can be especially complicated when patients with mental health conditions leave an integrated system, such as the Military Health System (MHS), and are required to manage their own care until they enter a new system. Considering how to navigate such transitions, the authors synthesize the evidence across existing evaluations.
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Research Questions
- What are the effects of mental health care transition programs?
- What are the effects of mental health care transition programs for transitions from military to veteran health care systems?
- Do effects vary by population?
- Do effects vary by intervention type?
- Do effects vary by country?
Although transitions between health care systems are common when patients move between jobs or insurers, they are especially difficult to navigate when patients with mental health conditions leave an integrated system, such as the Military Health System (MHS). The authors synthesize evidence from studies of interventions that facilitate transitions between mental health care systems, such as the transition from the MHS to the Veterans Health Administration (VHA).
The authors searched multiple research databases, reference-mined bibliographies of existing reviews, and consulted with experts to identify existing evaluations of transition support interventions. Key informants helped identify pertinent populations of interest who are transitioning between health care systems.
Seventeen studies evaluating different approaches met inclusion criteria. Studies reported on different outcomes, and few could be combined in aggregated analyses. Analyses showed that care transition interventions can increase outpatient mental health service use, but the overall body of evidence is limited.
Key Findings
- Evaluated interventions included health coaching, care coordination, and service navigation, as well as combinations of each intervention type.
- The authors found no consistent effects of care transition interventions across studies and outcomes, but interventions may increase outpatient mental health service use.
- Indirect comparisons across populations were limited by the small number of studies in included patient subgroups. In the only study examining service members entering civilian life, a care transition intervention reduced mental health symptoms.
- Additional research on interventions for care transitions among patients with mental health conditions is needed.
Table of Contents
Chapter One
Introduction
Chapter Two
Methods
Chapter Three
Results
Chapter Four
Discussion
Appendix A
Search Strategies
Appendix B
Evidence Table
Appendix C
Critical Appraisal Table
Appendix D
Excluded Studies and Background Literature
Research conducted by
This research was sponsored by the Psychological Health Center of Excellence and was conducted within the Forces and Resources Policy Center of the RAND National Security Research Division (NSRD).
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