title: Use of Peer Staff in a Critical Time Intervention for Frequent Users of a Psychiatric Emergency Room.
abstract: Project Connect, a clinical demonstration program developed in consultation with the New York State Office of Mental Health, adapted critical time intervention for frequent users of a large urban psychiatric emergency room (ER). Peer staff provided frequent users with time-limited care coordination. Participants increased their use of outpatient services over 12 months, compared with a similar group not enrolled in the program. For persons with significant general medical, psychiatric, and social needs, provision of this intervention alone is unlikely to reduce reliance on ERs, especially among homeless individuals.
authors.affiliation: Dr. Nossel 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: irn1@cumc.columbia.edu ). Dr. Lee and Dr. Herman are with the Silberman School of Social Work, Hunter College, City University of New York, New York City. Ms. Isaacs is with the Department of Healthcare Policy and Research, Weill Cornell Medical College, New York City. At the time this work was done, Dr. Marcus was with the Department of Biostatistics, Mailman School of Public Health, Columbia University, New York City. She is currently an independent consultant. Marcela Horvitz-Lennon, M.D., M.P.H., is editor of this column.
authors.forename: Ilana R
authors.initials: IR
authors.lastname: Nossel
authors.affiliation: Dr. Nossel 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: irn1@cumc.columbia.edu ). Dr. Lee and Dr. Herman are with the Silberman School of Social Work, Hunter College, City University of New York, New York City. Ms. Isaacs is with the Department of Healthcare Policy and Research, Weill Cornell Medical College, New York City. At the time this work was done, Dr. Marcus was with the Department of Biostatistics, Mailman School of Public Health, Columbia University, New York City. She is currently an independent consultant. Marcela Horvitz-Lennon, M.D., M.P.H., is editor of this column.
authors.forename: Rufina J
authors.initials: RJ
authors.lastname: Lee
authors.affiliation: Dr. Nossel 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: irn1@cumc.columbia.edu ). Dr. Lee and Dr. Herman are with the Silberman School of Social Work, Hunter College, City University of New York, New York City. Ms. Isaacs is with the Department of Healthcare Policy and Research, Weill Cornell Medical College, New York City. At the time this work was done, Dr. Marcus was with the Department of Biostatistics, Mailman School of Public Health, Columbia University, New York City. She is currently an independent consultant. Marcela Horvitz-Lennon, M.D., M.P.H., is editor of this column.
authors.forename: Abby
authors.initials: A
authors.lastname: Isaacs
authors.affiliation: Dr. Nossel 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: irn1@cumc.columbia.edu ). Dr. Lee and Dr. Herman are with the Silberman School of Social Work, Hunter College, City University of New York, New York City. Ms. Isaacs is with the Department of Healthcare Policy and Research, Weill Cornell Medical College, New York City. At the time this work was done, Dr. Marcus was with the Department of Biostatistics, Mailman School of Public Health, Columbia University, New York City. She is currently an independent consultant. Marcela Horvitz-Lennon, M.D., M.P.H., is editor of this column.
authors.forename: Daniel B
authors.initials: DB
authors.lastname: Herman
authors.affiliation: Dr. Nossel 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: irn1@cumc.columbia.edu ). Dr. Lee and Dr. Herman are with the Silberman School of Social Work, Hunter College, City University of New York, New York City. Ms. Isaacs is with the Department of Healthcare Policy and Research, Weill Cornell Medical College, New York City. At the time this work was done, Dr. Marcus was with the Department of Biostatistics, Mailman School of Public Health, Columbia University, New York City. She is currently an independent consultant. Marcela Horvitz-Lennon, M.D., M.P.H., is editor of this column.
authors.forename: Sue M
authors.initials: SM
authors.lastname: Marcus
authors.affiliation: Dr. Nossel 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: irn1@cumc.columbia.edu ). Dr. Lee and Dr. Herman are with the Silberman School of Social Work, Hunter College, City University of New York, New York City. Ms. Isaacs is with the Department of Healthcare Policy and Research, Weill Cornell Medical College, New York City. At the time this work was done, Dr. Marcus was with the Department of Biostatistics, Mailman School of Public Health, Columbia University, New York City. She is currently an independent consultant. Marcela Horvitz-Lennon, M.D., M.P.H., is editor of this column.
authors.forename: Susan M
authors.initials: SM
authors.lastname: Essock
mesh_terms: D000328:Adult; D016001:Confidence Intervals; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006703:Ill-Housed Persons / Q000523:psychology*; D006786:Hospitals, Urban; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000628:therapy; D008605:Mental Health Services / Q000706:statistics & numerical data*; D008875:Middle Aged; D009518:New York; D016017:Odds Ratio; D010351:Patient Discharge; D010359:Patient Readmission; D040242:Risk Reduction Behavior; D012720:Severity of Illness Index; D013997:Time Factors