The journal of behavioral health services & research
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J Behav Health Serv Res · Nov 2002
Comparative StudySelf-reported lifetime psychiatric hospitalization histories of jail detainees with mental disorders: comparison with a non-incarcerated national sample.
Lack of access to hospitalization is an often-cited risk factor for incarceration among persons with severe mental illness. This proposition is examined by comparing self-reports of lifetime psychiatric hospitalization histories of mentally ill jail inmates with data from a national sample of non-incarcerated mentally ill. ⋯ The data call into question the notion that mentally ill jail inmates have reduced access to psychiatric inpatient treatment, without addressing the adequacy of the treatment received. Longitudinal studies are needed to explore temporal relationships to better understand the relationship between mental health treatment and criminal justice involvement.
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J Behav Health Serv Res · May 2002
Administrative, clinical, and ethical issues surrounding the use of waiting lists in the delivery of mental health services.
The waiting list is commonly used in the delivery of mental health services. Despite their prevalence, their design and management are generally not standardized; rather, they take place on an ad hoc basis as a response to undesirable circumstances. The formulation and management of a waiting list initially appear to be simple, straightforward, and benign. ⋯ This article delineates the costs and benefits involved in the use of waiting lists. It outlines administrative, clinical, and ethical issues intrinsic in the use of waiting lists and provides recommendations aimed at assisting in their design and management. While recommendations encompassing the range of possible unique situations are impractical, guidelines for consideration of important variables are provided.
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J Behav Health Serv Res · Feb 2002
Comparative StudyMental health service use and cost of care for older adults in assisted living facilities: implications for public policy.
With changing demographics prompting greater demand for assisted living facility (ALF) care, indigent older adults with mental health needs face underfunded residential care options and mental health systems currently unprepared to meet their service requirements. In particular, over-reliance on inpatient mental health services for older individuals with mental illness and inadequate reimbursement of ALF facilities potentially increase costs and threaten availability of ALF care. This article analyzes Florida's administrative data and presents findings on mental health service use and cost of care for poor older persons. Using Florida as an example, the authors recommend policy changes to ensure the quality and availability of residential care for low-income adults with mental health needs.
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J Behav Health Serv Res · Aug 2001
Comparative StudyNational estimates of mental health utilization and expenditures for children in 1998.
No recent national data on expenditures and utilization are available to provide a benchmark for reform of mental health systems for children and adolescents. The most recent estimates, from 1986, predate the dramatic growth of managed care. This study provides updated national estimates. ⋯ Outpatient services account for 57%, inpatient for 33%, and psychotropic medications for 9% of the total. Unlike earlier reports, outpatient care now accounts for the majority of expenditures. This finding replicates the differences between recent managed care data and earlier actuarial databases for privately insured adults and confirms the trend from inpatient toward outpatient care.
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J Behav Health Serv Res · May 2001
ReviewPrevention research and its actual application to health services.
The effectiveness of alcohol abuse programs, whether to treat or to prevent, is of major importance to health services research. Demonstrating effectiveness has been appropriate to establish a sound scientific basis for these programs and to increase public acceptance. ⋯ In the end, health services policy deliberations are optimally based on what effect is delivered for the cost of the service, not simply on a determination of which service is the most effective. However, in a time of scarce resources prevention should be studied with the same rigor as treatment in order to determine the best return on investment.