Back to Journals » Patient Preference and Adherence » Volume 11

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

Authors Velligan DI, Fredrick M, Sierra C, Hillner K, Kliewer J, Roberts DL, Mintz J

Received 13 January 2017

Accepted for publication 7 March 2017

Published 12 May 2017 Volume 2017:11 Pages 919—928

DOI https://doi.org/10.2147/PPA.S132339

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Qian Ding

Peer reviewer comments 2

Editor who approved publication: Dr Johnny Chen

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

Department of Psychiatry, University of Texas Health Science Center San Antonio, San Antonio, TX, USA
Dr John Kliewer passed away on April 5, 2017


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.

Keywords: shared decision making, mental illness, community mental health, patient education

Creative Commons License This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.

Download Article [PDF]  View Full Text [HTML][Machine readable]

 

Other article by this author: