OBJECTIVE: The purpose of the study was to develop a descriptive profile
of heavy users of services in the South Australian Mental Health Services.
METHODS: Case notes for 50 heavy users were reviewed to obtain demographic
and diagnostic information and data on service use over a three-year
period. To supplement and verify this information, 35 of the patients were
given structured interviews. RESULTS: The mean age of the 50 patients was
34.9 years, and there was a slight predominance of females. Most patients
had never married and had been unemployed for a long time. All had a low
income. The mean number of years of education was ten. The group was
seriously disabled by psychiatric illness. The most common diagnosis was
schizophrenia, followed by schizoaffective disorder and bipolar disorder.
Comorbid axis I disorder and personality disorder or physical illness was
common. Drug and alcohol abuse often complicated patient management and
patients' ability to live successfully in the community. The average annual
cost per patient was $13,598 (Australian), largely from inpatient care.
CONCLUSIONS: This study contributes to an emerging global profile of the
heavy service user. Such a profile may help service systems identify
patients in this subgroup and target management strategies to these often
very disadvantaged and challenging patients.