Outreach to veterans with serious mental illness who are lost to care: Predictors of outreach contact.

Burton, Cynthia; Abraham, Kristen M.; Grindle, Chelsea M.; Visnic, Stephanie; Hack, Samantha M.; McCarthy, John F.; Bowersox, Nicholas W.

doi:10.1037/ser0000140

Cited by 5 publications

(5 citation statements)

References 11 publications

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“…A second survival analysis ( 16) with propensity scoring (12,13) assessed the effect of return to care via SMI Re-Engage on mortality among veterans who were contacted through SMI Re-Engage (18)(19)(20)(21)(22)(23) [see online supplement]. Individuals who did not die within the time frame were censored.…”

Section: Statistical Analysesmentioning

confidence: 99%

“…A bivariate analysis was used to assess the unadjusted association between contact and type of return-to-care visit (inpatient stay or emergency department visit versus outpatient visit) [see online supplement]. Logistic regression weighted for the propensity to be contacted and including the covariates described above was used to assess the adjusted association between contact and type of return-to-care visit (18)(19)(20)(21)(22)(23) [see online supplement].…”

Section: Statistical Analysesmentioning

confidence: 99%

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Enhancing Treatment Reengagement for Veterans With Serious Mental Illness: Evaluating the Effectiveness of SMI Re-Engage

Abraham

Mach

Visnic

et al. 2018

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Section: Statistical Analysesmentioning

confidence: 99%

Section: Statistical Analysesmentioning

confidence: 99%

Enhancing Treatment Reengagement for Veterans With Serious Mental Illness: Evaluating the Effectiveness of SMI Re-Engage

Abraham

Mach

Visnic

et al. 2018

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“…A second possibility was differences in symptom severity at baseline, and we identified more severe psychiatric symptoms in the group who dropped out. This is troublesome as persons presumably at greater risk were more likely not to engage in treatment, and this mirrors findings concerning higher acuity/complexity as a predictor of treatment disengagement in SMI (Burton et al, 2018).…”

Section: Discussionmentioning

confidence: 52%

Pilot feasibility trial of a brief mobile-augmented suicide prevention intervention for serious mental illness.

Depp¹,

Parrish²,

Chalker³

et al. 2023

Psychiatric Rehabilitation Journal

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Objective: People with serious mental illnesses (SMIs) are at high risk for suicidal ideation and behavior, and yet few suicide prevention interventions have been customized for this group. We describe the outcomes of a pilot trial of Mobile SafeTy And Recovery Therapy (mSTART), a four-session suicide-focused cognitive behavioral intervention for SMI, designed for the transition from acute to outpatient care and augmented with ecological momentary intervention to reinforce intervention content. Methods: The primary objective of this pilot trial was to evaluate the feasibility, acceptability, and preliminary effectiveness of START. Seventy-eight people with SMI and elevated suicidal ideation were randomized to either: (a) mSTART or (b) START alone (i.e., without mobile augmentation). Participants were evaluated at baseline, 4 weeks (end of in-person sessions), 12 weeks (end of mobile intervention), and 24 weeks. The primary outcome of the study was change in suicidal ideation severity. Secondary outcomes included psychiatric symptoms, coping self-efficacy, and hopelessness. Results: A total of 27% of randomized persons were lost to follow-up after baseline, and engagement with mobile augmentation was variable. There was clinically significant improvement (d = 0.86) in suicidal ideation severity scores sustained over 24 weeks, with similar effects seen for secondary outcomes. Preliminary comparison indicated a medium effect size (d = 0.48) advantage at 24 weeks of mobile augmentation in suicidal ideation severity scores. Treatment credibility and satisfaction scores were high. Conclusions and Implications for Practice: START, regardless of mobile augmentation, was associated with sustained improvement in suicidal ideation severity and secondary outcomes in people with SMI at-risk for suicide in this pilot trial. Impact and ImplicationsThis pilot study tested a new brief intervention designed to target suicide ideation in at-risk people with SMIs, focusing on the gap period between urgent and ongoing care. We found that the intervention, which included both in-person and mobile technology components, was feasible, acceptable, and linked with sustained improvement in suicide ideation. Although a pilot study, this research suggests that brief suicidespecific interventions adapted for people with SMIs could be helpful in bridging acute to outpatient care.

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“…Also, with an estimated 37,000 veterans experiencing homelessness [ 112 ], the need is high for homelessness support following transition [ 103 ]. Post-transition care is particularly challenging for homeless veterans, with whom it is difficult for the health care system to maintain consistent and frequent contact [ 113 ]. In addition, veterans who are involved in multiple systems of care through being dually both enrolled in the VA health care system and also receive non-VA medical care (e.g., through Medicare coverage) are deemed particularly at risk for care that is not well coordinated [ 114 ], and this poses challenges for when a care transition involves the additional dimension of transitioning across care system boundaries.…”

Section: Resultsmentioning

confidence: 99%

Characterization of multilevel influences of mental health care transitions: a comparative case study analysis

Dickson

Sklar

Chen

et al. 2022

BMC Health Serv Res

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Purpose Mental health care transitions are increasingly prioritized given their potential to optimize care delivery and patient outcomes, especially those focused on the transition from inpatient to outpatient mental health care. However, limited efforts to date characterize such mental health transition practices, especially those spanning multiple service setting contexts. Examination of key influences of inpatient to outpatient mental health care transitions across care contexts is needed to inform ongoing and future efforts to improve mental health care transitions. The current work aims to characterize multilevel influences of mental health care transitions across three United States-based mental health system contexts. Methods A comparative multiple case study design was used to characterize transition practices within the literature examining children’s, non-VA adult, and VA adult service contexts. Andersen’s (1995) Behavioral Health Service Use Model was applied to identify and characterize relevant distinct and common domains of focus in care transitions across systems. Results Several key influences to mental health care transitions were identified spanning the environmental, individual, and health behavior domains, including: community capacity or availability, cross-system or agency collaboration, provider training and experience related to mental health care transitions, client care experience and expectations, and client clinical characteristics or complexity. Conclusions Synthesis illustrated several common factors across system contexts as well as unique factors for further consideration. Our findings inform key considerations and recommendations for ongoing and future efforts aiming to plan, expand, and better support mental health care transitions. These include timely information sharing, enhanced care coordination and cross setting and provider communication, continued provider/client education, and appropriate tailoring of services to improve mental health care transitions.

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Outreach to veterans with serious mental illness who are lost to care: Predictors of outreach contact.

Cited by 5 publications

References 11 publications

Enhancing Treatment Reengagement for Veterans With Serious Mental Illness: Evaluating the Effectiveness of SMI Re-Engage

Enhancing Treatment Reengagement for Veterans With Serious Mental Illness: Evaluating the Effectiveness of SMI Re-Engage

Pilot feasibility trial of a brief mobile-augmented suicide prevention intervention for serious mental illness.

Characterization of multilevel influences of mental health care transitions: a comparative case study analysis

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