Psychiatric services : a journal of the American Psychiatric Association
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Comparative Study
Psychiatric emergency service use and homelessness, mental disorder, and violence.
This study examined relationships between homelessness, mental disorder, violence, and the use of psychiatric emergency services. To the authors' knowledge, this study is the first to examine these issues for all episodes of care in a psychiatric emergency service that serves an entire mental health system in a major city. ⋯ Homeless individuals with mental disorders accounted for a large proportion of persons who received psychiatric emergency services in the community mental health system in the urban setting of this study. The co-occurrence of homelessness, mental disorder, substance abuse, and violence represents a complicated issue that will likely require coordination of multiple service delivery systems for successful intervention. These findings warrant consideration in public policy initiatives. Simply diverting individuals with these problems from the criminal justice system to the community mental health system may have limited impact unless a broader array of services can be brought to bear.
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Comparative Study
Psychiatric emergency service use after implementation of managed care in a public mental health system.
This study examined whether implementation of managed care in a public mental health system affected return visits to psychiatric emergency services within 180 days of an index visit. ⋯ Managed care strategies are often used to reduce reliance on emergency services. In this study, managed care delayed, rather than prevented, return visits to the psychiatric emergency service.
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Comparative Study
Trends in U.S. emergency department visits for mental health conditions, 1992 to 2001.
The objective of this study was to ascertain trends in mental health-related visits to U.S. emergency departments. ⋯ Mental health-related visits constitute a significant and increasing burden of care in U.S. emergency departments.