Consultative intervention to improve outcomes of high utilizers in a public mental health system.
OBJECTIVE
To examine the effectiveness of an academic consultation on outcomes among consumers in a public mental health system and to compare outcomes between high-cost/high-utilizer and midcost consumers.


METHODS
Participants (N = 36) completed all questionnaires during three semistructured interviews. Using a repeated-measures experimental design, the outcomes of global functioning, quality of life, service use and need, costs, and consumer satisfaction were examined.


RESULTS
The hypothesis that consultation would change medication practices and reduce costs was supported.


CONCLUSIONS
Consultation with a senior clinician helped change medication practices and reduced costs. Consultation may lead to recognition of a new diagnosis (medical, neurologic, or psychiatric) or suggestions for modifying a treatment regimen that could improve functioning and QOL. In a busy public mental health system, there is often little time for consultation and little thought to second opinions. For clients who cost the system the greatest amount, the small additional cost of a consultation is a good potential investment.
College of Nursing, The University of Arizona, Tucson, AZ, USA. Tbadger@nursing.arizona.edu
Terry
T
Badger
Alan J
AJ
Gelenberg
Michael
M
Berren
D000328:Adult; D000368:Aged; D019090:Case Management / Q000191:economics; D003363:Cost Control; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000191:economics / Q000628:therapy*; D008605:Mental Health Services / Q000191:economics* / Q000706:statistics & numerical data; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000191:economics; D017060:Patient Satisfaction; D011635:Public Health Administration / Q000592:standards*; D011788:Quality of Life; D015206:Southwestern United States