Past Releases: Bridging Gaps Between Inpatient and Outpatient Settings
National Council for Community Behavioral Healthcare Releases
Experts’ Recommendations for Bridging Gaps Between Inpatient and Outpatient Settings
Contact Communications@thenationalcouncil.org or 301-984-6200, ext. 228
Las Vegas (March 27, 2007) — Hospitals and community-based organizations need uniform standards, education and better collaboration to ensure that schizophrenia patients who fail to show up for treatment following hospital discharge are not forgotten. Seeking to stem the tide of patients who are “lost in transition” every day, the National Council for Community Behavioral Healthcare assembled a 24-member independent panel of experts to develop a consensus approach of coordination between inpatient and outpatient settings and engage people with mental illness in continued care. The panel included representatives from leading accrediting bodies and hospital and community treatment organizations as well as patients, family members, researchers, state authorities, and psychiatric leaders.
“Millions of Americans experience schizophrenia or other serious mental illnesses and the most vulnerable period in their recovery is the transition from the hospital to local, community-based services,” said Linda Rosenberg, President and Chief Executive Officer, National Council for Community Behavioral Healthcare. “If they don’t get continued care, we must all face the serious human, social and financial consequences.”
Lack of appropriate follow-up care after discharge from inpatient treatment results in increased costs to the community through re-hospitalization, increased emergency room use, and potential police involvement.
The National Council released recommendations to address this gap in care, today at its 37th Annual Conference in Las Vegas. These recommendations, which span the administrative, professional and human elements required to ensure complete continuity of care, include:
- Encourage collaborations between hospitals and community-based organizations;
- Use a quality improvement approach to enhance continuity of therapy by benchmarking performance and outcomes standards at the organizational level;
- Ensure all patients have a level of care management for the transition from inpatient to community including reimbursable care management services by all payers;
- Focus on the “Pull Model” of transition from inpatient to outpatient care by involving community providers in the transition before they are discharged from the hospital;
- Align accreditation standards that address and improve continuity of therapy;
- Educate patients and their families on importance of maintaining a personal health care history;
- Promote more thoughtful use of inpatient services to reduce emergency room use and an eventual decrease in the number of hospitalizations;
- Share data about mental health services with appropriate organizations in usable and timely ways; and,
- Involve patients and their advocates in all levels of system delivery and evaluation.
CONTINUITY OF CARE: SYSTEMIC CHALLENGES AND BENEFITS
A scarcity of resources and lack of communication, cooperation and coordination of treatment and services often results in individuals discharged from inpatient settings being placed on long waiting lists for community-based programs. Treatment history is not always transferred from one provider to another or there can be challenges with medication supplies that could lead to an interruption, if not a discontinuation, of care.
“Many people with mental illness are ‘falling between the cracks’ when shifting from an acute inpatient setting into the community, often stopping the recovery process altogether,” said Joseph Parks, M.D., Medical Director, Missouri Department of Mental Health and member of the National Council’s independent panel. "Interruptions of treatment interfere with recovery and prevent people from being able to function as contributing members of their community.”
Continuity of care supports patient recovery and re-entry into the community and has a positive, measurable impact on the healthcare delivery system in terms of:
- Reduced incidence of use of emergency room services by people with schizophrenia or other serious mental illnesses
- Shorter length of inpatient hospitalizations
- Access to appropriate treatment settings
- Enhanced efficiencies across the discharge planning process
Worldwide, it is estimated that one person in every 100 develops schizophrenia, one of the most serious types of mental illness. It is marked by positive symptoms (hallucinations and delusions) and negative symptoms (depression, blunted emotions and social withdrawal) as well as by disorganized thinking.
Members of the National Council consensus panel, formed in December 2006, include representatives from the American Association of Community Psychiatrists (AACP), Assertive Community Treatment Association (ACTA), Commission on Accreditation of Rehabilitation Facilities (CARF), Mental Health America (MHA), National Alliance on Mental Illness (NAMI), National Association of Psychiatric Health Systems (NAPHS), National Association of Social Workers (NASW), National Association of State Mental Health Program Directors (NASMHPD), National Council for Community Behavioral Healthcare, Substance Abuse and Mental Health Services Administration (SAMHSA), Constella Group and consumers. The panel was supported by Janssen, L.P.
The National Council for Community Behavioral Healthcare is a not-for-profit 501(c)(3) association representing 1,300 mental health and addictions treatment and rehabilitation organizations that serve nearly six million adults, children, and families in communities across America.