title: Reengagement of high-need individuals with serious mental illness after discontinuation of services.
abstract: OBJECTIVE
  The study determined rates of reengagement in services for individuals with serious mental illness who had discontinued services.
  
  
  METHODS
  As part of a quality assurance program in New York City involving continuous review of Medicaid claims and other administrative data, clinician care monitors identified 2,834 individuals with serious mental illness who were apparently in need of care but disengaged from services. The care monitors reviewed monthly updates of Medicaid claims, encouraged outreach from providers who had previously worked with identified individuals, and determined whether individuals had reengaged in services.
  
  
  RESULTS
  Reengagement rates over a 12-month follow-up period were low, particularly for individuals who had been incarcerated or for whom no service provider was available to provide outreach.
  
  
  CONCLUSIONS
  Subgroups of disengaged individuals with serious mental illness have different rates of reengagement. Active outreach by providers might benefit some, but such targeting is inefficient when the individual cannot be located.
authors.affiliation: Dr. Smith and Dr. Essock are with the Department of Psychiatry, College of Physicians and Surgeons, Columbia University, and with the New York State Psychiatric Institute, New York City (e-mail: tes2001@columbia.edu ). Dr. Stein is with the Department of Psychiatry, University of Pittsburgh, and with RAND Corporation, Pittsburgh. Ms. Donahue is with the New York State Office of Mental Health, Albany. Mr. Sorbero is with Community Care Behavioral Health Organization, Pittsburgh. Dr. Karpati is with the International Union Against Tuberculosis and Lung Disease, New York City. Ms. Marsik is with the New York City Department of Health and Mental Hygiene. Dr. Myers and Ms. Appel are with the New York State Office of Mental Health, Albany and New York City. Ms. Thomann-Howe is with Harlem United, New York City.
authors.forename: Thomas E
authors.initials: TE
authors.lastname: Smith
authors.forename: Bradley D
authors.initials: BD
authors.lastname: Stein
authors.forename: Sheila A
authors.initials: SA
authors.lastname: Donahue
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Sorbero
authors.forename: Adam
authors.initials: A
authors.lastname: Karpati
authors.forename: Trish
authors.initials: T
authors.lastname: Marsik
authors.forename: Robert W
authors.initials: RW
authors.lastname: Myers
authors.forename: Doreen
authors.initials: D
authors.lastname: Thomann-Howe
authors.forename: Anita
authors.initials: A
authors.lastname: Appel
authors.forename: Susan M
authors.initials: SM
authors.lastname: Essock
mesh_terms: D006297:Health Services Accessibility; D006801:Humans; D008484:Medicaid; D001523:Mental Disorders / Q000628:therapy; D008605:Mental Health Services / Q000706:statistics & numerical data*; D009519:New York City; D010342:Patient Acceptance of Health Care; D011785:Quality Assurance, Health Care; D012720:Severity of Illness Index; D014481:United States