title: Shifts in case mix and locus of mental health care for Washington State adults with severe mental illness.
abstract: The author describes outcomes of interventions that were aimed at decreasing high use of state hospitals. Research focused on changes in state hospital case mix and dynamics of use by individuals identified as "high utilizers" before and after the Washington State Mental Health Division (MHD) implemented a series of interventions designed to reduce use. A set of recommendations are offered for policymakers who plan interventions that shift the locus of care for severely and persistently mentally ill adults.
authors.affiliation: School of Social Work, University of Washington, Seattle 98105-6299, USA.
authors.forename: J
authors.initials: J
authors.lastname: Semke
mesh_terms: D000328:Adult; D003155:Community Mental Health Centers / Q000706:statistics & numerical data* / Q000639:trends; D003953:Diagnosis-Related Groups / Q000639:trends*; D018166:Health Care Reform / Q000458:organization & administration; D006302:Health Services Research; D006764:Hospitals, Community / Q000706:statistics & numerical data* / Q000639:trends; D006778:Hospitals, Psychiatric / Q000706:statistics & numerical data / Q000639:trends; D006783:Hospitals, State / Q000706:statistics & numerical data* / Q000639:trends; D006801:Humans; D001523:Mental Disorders / Q000628:therapy*; D008875:Middle Aged; D014861:Washington