An outcomes evaluation of a community support program for persons with persistent and severe mental illness
Jose Rossy-Millan (2000)
This dissertation involves an outcomes evaluation of a program that provides intensive services to adults with severe mental illness in eastern Massachusetts. This program has adapted the Program for Assertive Community Treatment (PACT) model to provide a brief intervention (less than three months) upon discharge from a psychiatric hospitalization. A typical intervention includes wrap-around and intensive case management in order to help clients connect with sustainable services and supports in their communities. The program offers a comprehensive array of services, including 24-hour outreach to clients at their residences, voluntary respite care, and a drop-in center. Data on psychiatric hospitalizations and total days hospitalized were obtained for 43 program clients for the two-year period immediately preceding admission to the program and the two year period following discharge. Analyses using Wilcoxon Signed Ranks Tests provide support for the research hypotheses in that they found a significant reduction on the number of hospitalizations for up to two years post discharge from ICS. Additionally, clients who were hospitalized had shorter hospitalizations than they had on the past. A logit log-linear model found that clients with a history of alcoholism and those from lower socioeconomic status tended to have higher rates of psychiatric hospitalizations and longer hospital stays. The author discusses limitations of the present study, as well as strategies to overcome them in the future. These include a discussion of standardized instruments that may be used to monitor program effectiveness, as well as specific recommendations on research design and statistical analyses that can further our understanding of effective treatment for persons with severe mental illness.