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OBJECTIVES To describe models of integrated care used in the United States, assess how integration of mental health services into primary care settings or primary health care into specialty outpatient settings impacts patient outcomes and describe barriers to sustainable programs, use of health information technology (IT), and reimbursement structures of(More)
BACKGROUND Patient Outcomes Research Team treatment recommendations were used to investigate the relationship between patient characteristics and higher-than-recommended dosages (> 1000 chlorpromazine equivalents [CPZe]) at discharge. METHOD Inpatients who met the DSM-IV criteria for schizophrenia or schizoaffective disorder were recruited from 4 general(More)
In this paper, we examine sources of gender differences in depressive symptoms among adolescents. Using data collected from a self-administered survey of 306 high school students, we examine differences in the impact of life events, psychosocial resources, and parent-child relationships on levels of psychological distress. Our results confirm a substantial(More)
OBJECTIVE The study examined patterns of care for persons with mental illness in nursing homes in the United States from 1985 to 1995. During that period resident populations in public mental hospitals declined, and legislation aimed at diverting psychiatric patients from nursing homes was enacted. METHODS Estimates of the number of current residents with(More)
OBJECTIVE Applying the schizophrenia treatment guidelines established by the Patient Outcomes Research Team (PORT) project, this study evaluated whether antipsychotic medication dosage influenced patient outcomes in routine clinical settings. METHODS The associations between discharge antipsychotic medication dosage and short-term clinical, social, and(More)
OBJECTIVE The authors examine patterns in utilization of psychiatric inpatient services by children and adolescents in general hospitals during 1988-1995. METHOD National Hospital Discharge Survey data were used to describe utilization patterns for children and adolescents with primary psychiatric diagnoses in general hospitals from 1988 to 1995. (More)
Using data from the National Hospital Discharge Survey and the Inventory of Mental Health Organizations, this article examines national trends in psychiatric inpatient care from 1988 to 1994 in general hospitals and mental hospitals. We find that discharges with a primary diagnosis of mental illness in general hospitals increased from 1.4 to 1.9 million(More)
OBJECTIVE To assess pragmatic challenges faced when implementing, delivering, and sustaining models of integrated mental health intervention in primary care settings. Thirty percent of primary care patients with chronic medical conditions and up to 80% of those with health complexity have mental health comorbidity, yet primary care clinics rarely include(More)
OBJECTIVE The substantial failure of psychiatric patients to engage in outpatient specialty mental health care after an acute hospitalization at a time when managed care companies and others increasingly hold hospitals accountable for outcomes underscores the importance of identifying patients at high risk for not completing referrals. This study explored(More)