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Brief Reports   |    
Reengagement of High-Need Individuals With Serious Mental Illness After Discontinuation of Services
Thomas E. Smith, M.D.; Bradley D. Stein, M.D., Ph.D.; Sheila A. Donahue, M.A.; Mark J. Sorbero, M.S.; Adam Karpati, M.D.; Trish Marsik; Robert W. Myers, Ph.D.; Doreen Thomann-Howe, L.C.S.W.; Anita Appel, L.C.S.W.; Susan M. Essock, Ph.D.
Psychiatric Services 2014; doi: 10.1176/appi.ps.201300549
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Dr. Smith and Dr. Essock are with the Department of Psychiatry, College of Physicians and Surgeons, Columbia University, and with the New York State Psychiatric Institute, New York City (e-mail: tes2001@columbia.edu). Dr. Stein is with the Department of Psychiatry, University of Pittsburgh, and with RAND Corporation, Pittsburgh. Ms. Donahue is with the New York State Office of Mental Health, Albany. Mr. Sorbero is with Community Care Behavioral Health Organization, Pittsburgh. Dr. Karpati is with the International Union Against Tuberculosis and Lung Disease, New York City. Ms. Marsik is with the New York City Department of Health and Mental Hygiene. Dr. Myers and Ms. Appel are with the New York State Office of Mental Health, Albany and New York City. Ms. Thomann-Howe is with Harlem United, New York City.

Copyright © 2014 by the American Psychiatric Association


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.

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Figure 1 Rates of reengagement for 2,820 high-need individuals who had discontinued services, by outreach category


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