title: Continuity of care and client outcomes in the Robert Wood Johnson Foundation program on chronic mental illness.
abstract: The impact on services and outcomes of the local mental health authorities (LMHAs) developed under the RWJF Program on Chronic Mental Illness (CMI) was evaluated in Baltimore, Cincinnati, Columbus, and Toledo. Two cohorts of clients with CMI discharged from an episode of acute 24-hour care were recruited in each city: the first cohorts were drawn shortly after the demonstration began and the second, two years later. The LMHAs in the three Ohio cities increased case management for the second cohorts at two months, but not at 12 months, after hospital discharge. The second cohorts in Baltimore and Cincinnati experienced lower turnover among case managers during the year after discharge, but there was no significant improvement in client outcomes. Creation of LMHAs may be a necessary, but not sufficient, step toward improving outcomes and should be followed by improvement in the quantity and quality of services.
authors.affiliation: Center for Mental Health Services Research, University of Maryland School of Medicine, Baltimore.
authors.forename: A F
authors.initials: AF
authors.lastname: Lehman
authors.forename: L T
authors.initials: LT
authors.lastname: Postrado
authors.forename: D
authors.initials: D
authors.lastname: Roth
authors.forename: S W
authors.initials: SW
authors.lastname: McNary
authors.forename: H H
authors.initials: HH
authors.lastname: Goldman
mesh_terms: D002908:Chronic Disease / Q000191:economics; D015331:Cohort Studies; D003156:Community Mental Health Services / Q000191:economics / Q000458:organization & administration*; D003266:Continuity of Patient Care / Q000458:organization & administration* / Q000706:statistics & numerical data; D005260:Female; D005381:Financing, Organized; D005582:Foundations; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000191:economics / Q000628:therapy; D010347:Patient Care Planning / Q000458:organization & administration; D016896:Treatment Outcome; D014481:United States