Project ASSERT: An ED-Based Intervention to Increase Access to Primary Care, Preventive Services, and the Substance Abuse Treatment System

Bernstein, Edward; Bernstein, Judith; Levenson, Suzette

doi:10.1016/s0196-0644(97)70140-9

Cited by 249 publications

(212 citation statements)

References 14 publications

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“…In earlier studies, active linkage after psychiatric crisis improved function 16 and increased adherence to mental health care. 17 Nurse case management of persons with serious psychiatric disabilities is feasible and effective in both community and primary care office settings.…”

Section: Discussionmentioning

confidence: 82%

Connections to Primary Medical Care after Psychiatric Crisis

Griswold

Servoss²,

Leonard³

et al. 2005

The Journal of the American Board of Family Medicine

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Background: Patients presenting with a psychiatric emergency face a unique set of challenges in connecting to primary care.Objectives: We tested the hypothesis that, in contrast to usual care, case management will result in higher rates of connection to primary care. We examined variables affecting primary care entry, including insurance status, hospital admission, and concurrent linkages to mental health care.Research Design/Methods: This article reports on a preliminary outcome of an ongoing randomized controlled trial conducted with 101 patients presenting in an urban psychiatric setting. Patients were randomized to a case management team or to usual care. The need for medical care was assessed by documenting medical comorbidity.Results: Average age of the sample was 37.5; 65% were male, and 78% had low income; 37% were African American and 9% were Hispanic. Within 3 months of study enrollment, 57% of the intervention group was successfully linked to primary care compared with 16% of the usual care group, a difference that was statistically significant (P < .001). Associated positive predictors for linkage to primary care included mental health care visits and success in obtaining health insurance. Inpatient hospital stay at the time of psychiatric crisis was negatively associated with later attendance at primary care.

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Section: Discussionmentioning

confidence: 82%

Connections to Primary Medical Care after Psychiatric Crisis

Griswold

Servoss²,

Leonard³

et al. 2005

The Journal of the American Board of Family Medicine

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“…Emergency Department visits may represent a distinct population in greater need of preventive interventions [11], but also amenable to such interventions [12][13][14][15]. Given the important role of the Emergency Departments in providing "general medical care" to a distinctive subset of the population, it is not clear that the same relationships between parental depression and child outcomes apply.…”

mentioning

confidence: 99%

Child Injury Risks are Close to Home: Parent Psychosocial Factors Associated with Child Safety

Rhodes

Iwashyna

2007

Matern Child Health J

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Objective: In several populations, maternal depression has been associated with reduced child safety. In an urban pediatric Emergency Department, we examined the relationship between parental depression, social support, and domestic conflict and child safety behaviors.Methods: We studied consecutive patients in an Emergency Department. Trained interviewers used a structured instrument to assess patient, primary caregiver, and household demographics, socio-economic status, psychosocial factors, child safety behaviors (whether a gun was in the home, poisons were locked, a functioning smoke detector was present, and use of carseats or seatbelts), and whether the home was smokefree. 1,116 patients provided adequate data.Results: Depression was associated with a modest and not statistically significant reduction in child safety behaviors in this population. Lack of social support and the presence of domestic conflict were robustly, independently, and statistically significantly associated with less safe homes. Domestic conflict was associated with more smoking in the home.Conclusion: In our population, child safety was associated less with depression and more with parental lack of social support and domestic conflict. These can be assessed in a Emergency Department and may be amenable to intervention. Abstract Objective: In several populations, maternal depression has been associated with reduced child safety. In an urban pediatric Emergency Department, we examined the relationship between parental depression, social support, and domestic conflict and child safety behaviors.Methods: We studied consecutive patients in an Emergency Department. Trained interviewers used a structured instrument to assess patient, primary caregiver, and household demographics, socio-economic status, psychosocial factors, child safety behaviors (whether a gun was in the home, poisons were locked, a functioning smoke detector was present, and use of carseats or seatbelts), and whether the home was smoke-free. 1,116 patients provided adequate data.Results: Depression was associated with a modest and not statistically significant reduction in child safety behaviors in this population. Lack of social support and the presence of domestic conflict were robustly, independently, and statistically significantly associated with less safe homes. Domestic conflict was associated with more smoking in the home.Conclusion: In our population, child safety was associated less with depression and more with parental lack of social support and domestic conflict. These can be assessed in a Emergency Department and may be amenable to intervention.

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“…Thus, many patients initiating treatment as a result of SBIRT programs are considered early intervention, which numerous studies attribute as a critical factor in increased long-term success [51,52]. Similar programs used in emergency departments, such as Project ASSERT, have shown significant results towards identifying current or potential individuals with substance use disorder and providing appropriate treatment referrals [53]. Often times, SBIRT programs are integrated with counselling sessions to develop and channel patient motivation.…”

Section: Sbirt Programs For Health Care Delivery Centresmentioning

confidence: 99%

Access to Substance Use Disorder Treatment Services in Canada

McPherson¹,

Boyne²

2017

J Alcohol Drug Depend

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Substance use disorder is an increasingly challenging and widespread issue throughout Canada with significant barriers negatively impacting access for treatment seekers. This paper seeks to examine the salient factors prohibiting equitable access for these individuals, while exploring a series of pragmatic considerations for policymakers to advance system efficacy. Increasing demand, treatment availability, funding prioritization, and marginalized subgroups were identified as central factors impacting treatment access. A review of the current intervention programs to enhance access is discussed, in addition to areas for system improvement and methodological considerations for future research.

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Project ASSERT: An ED-Based Intervention to Increase Access to Primary Care, Preventive Services, and the Substance Abuse Treatment System

Cited by 249 publications

References 14 publications

Connections to Primary Medical Care after Psychiatric Crisis

Connections to Primary Medical Care after Psychiatric Crisis

Child Injury Risks are Close to Home: Parent Psychosocial Factors Associated with Child Safety

Access to Substance Use Disorder Treatment Services in Canada

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