title: A randomized trial: are care navigators effective in connecting patients to primary care after psychiatric crisis?
abstract: Persons with serious mental illnesses suffer excess medical morbidity compared to the general population. This RCT aimed to determine whether navigators are effective in helping patients connect to primary care after psychiatric crisis. Adults presenting for emergency care were randomly assigned to a navigator versus usual care. Navigators facilitated access to primary care. Outcomes were connection rates to medical care and the impact of health insurance, hospitalization and mental health care on primary care attendance. After 1 year, the intervention group was statistically more likely to access care, versus controls (62.4 vs. 37.6%, P < .001). Navigators were effective in helping patients connect to primary care after a psychiatric crisis. Improved access to primary care is important given the complex chronic health problems of this vulnerable cohort.
authors.affiliation: Department of Family Medicine, Primary Care Research Institute, The State University of New York at Buffalo, 462 Grider Street, SUNY Clinical Center, Buffalo, NY 14215, USA. griswol@buffalo.edu
authors.forename: Kim S
authors.initials: KS
authors.lastname: Griswold
authors.forename: Gregory G
authors.initials: GG
authors.lastname: Homish
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Pastore
authors.forename: Kenneth E
authors.initials: KE
authors.lastname: Leonard
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003156:Community Mental Health Services; D015897:Comorbidity; D003299:Cooperative Behavior; D003419:Crisis Intervention; D017831:Diagnosis, Dual (Psychiatry); D004636:Emergency Service, Hospital; D005260:Female; D005500:Follow-Up Studies; D006297:Health Services Accessibility; D006304:Health Status; D006801:Humans; D019458:Insurance Coverage; D033183:Interdisciplinary Communication; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000523:psychology / Q000534:rehabilitation*; D008875:Middle Aged; D011320:Primary Health Care; D011618:Psychotic Disorders / Q000175:diagnosis / Q000523:psychology / Q000534:rehabilitation*; D012017:Referral and Consultation; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000523:psychology / Q000534:rehabilitation*; D017664:Uncompensated Care; D014505:Urban Population; D055815:Young Adult