Abstract
Although unified public mental health care systems are optimal, most treatment is offered in non-systems, where the community and state have discrete responsibilities. This paper describes the implementation of a single system model of care for chronic and severely disturbed psychiatric patients in a large urban area. It involves a collaboration between a university's community mental health center and a state psychiatric hospital. Data about the impact of the project are presented, including admission and recidivism rates, census in hospital and alternatives, and linkage with community-based services. Discussion focuses on the implications for empirically-based capitation models, future clinical and research goals, and the administrative mandate required to achieve them.
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References
Appleby, L., Slagg, N., & Desai, P.N. (1981). The urban nomad: A psychiatric problem. In J.H. Masserman (Ed.),Current Psychiatric Therapies, Vol. 21. New York: Grune & Stratton.
Babigian, H.M., & Reed, S.K. (1987). An experimental model capitation payment system for the chronic mentally ill.Psychiatric Annals, 17, 604–609.
Bachrach, L.L. (1980). Overview: Model programs for chronic mental patients.American Journal of Psychiatry, 137, 1023–1031.
Bachrach, L.L. (1986). The future of the state mental hospital.Hospital and Community Psychiatry, 37, 467–474.
Bassuk, E.L., Gerson, S. (1978). Deinstitutionalization and mental health services.Scientific American, 238, 46–53.
Goldman, H.H., Pincus, H.A., Taube, C.A., & Regier, D.A. (1984). Prospective payment for psychiatric hospitalization: Questions and issues.Hospital and Community Psychiatry, 35, 460–464.
Gudeman, J.E., Shore, M.F., & Dickey, B. (1983). Day hospitalization and an inn instead of inpatient care for psychiatric patients.New England Journal of Medicine, 308, 749–753.
Gudeman, J.E., & Shore, M.F. (1984). Beyond deinstitutionalization: A new class of facilities for the mentally ill.New England Journal of Medicine, 311, 832–836.
Kiesler, C.A., McGuire, T., Mechanic, D., Mosher, L.R., Nelson, S.H., Newman, F. L., Rich, R., & Schulberg, H.C. (1983). Federal mental health policymaking.American Psychologist, 38, 1291–1297.
Leff, H.S., & Bradley, V.J. (1986). DRGs are not enough.American Psychologist, 41, 73–78.
Marshall, P.E. (1986). Integrated mental health: A creative model for community mental health in the 80's.Journal of Mental Health Administration, 13, 23–27.
Solomon, P., Gordon, B., & Davis, J.M. (1986). Reconceptualizating assumptions about community mental health.Hospital and Community Psychiatry, 37, 708–712.
Stein, L.I., & Test, M.A. (1980). Alternative to mental hospital treatment.Archives of General Psychiatry, 37, 392–397.
Talbott, J.A. (1983).Unified mental health system: Utopia unrealized. San Francisco: Jossey-Bass.
Talbott, J.A., & Robinowitz, C.B. (1986).Working together: State-university collaboration in mental health. Washington, DC: American Psychiatric Press.
Talbott, H.A. (1986). An introduction to state-university collaboration. In J.A. Talbott & C.B. Robinowitz (Eds.),Working together: State-university collaboration in mental health, Washington, DC: American Psychiatric Press.
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Pomp, H.C., McGovern, M.P. Psychiatric chronicity: A single system model. Adm Policy Ment Health 16, 79–87 (1988). https://doi.org/10.1007/BF00706106
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DOI: https://doi.org/10.1007/BF00706106