Barry Gordon

Outpatient compliance of psychiatric emergency room patients by presenting problems

In the present study, a cohort of patients who came to a psychiatric emergency room in a general hospital, and were not referred for hospitalization, were analyzed in regard to the amount and rate of subsequent contact with community mental health and substance abuse agencies. Patterns of service receipt and the differential impact of service use on hospitalization and/or return visits were analyzed by three major problem types: (1) psychiatric; (2) psychiatric/substance abuse; and (3) substance abuse. The analysis of these subgroups yielded valuable information about how the service system and/or different groups of patients in crisis respond to the system.

A comparison of perspectives on discharge of extended care facility clients: Views of families, hospital staff, community mental health workers, and clients

This article reports on the perspectives of family members, hospital staff, community mental health workers and clients, themselves, on issues relating to discharge of clients from a psychiatric extended care facility. Families and hospital staff had the most concerns about clients having problems after discharge. Clients had the least concerns. Highly structured and supervised placement options were considered by 74% of hospital staff, 60% of community mental health workers and 44% of families to be the likely placement for clients but only 25% of clients selected this as an option. Approximately one-half of the hospital and community staff felt remaining in the hospital was the best alternative. Without the development of community placement and supportive alternatives, the extended-care facilities will continue to fill this gap in the mental health service delivery system.

Comparison of outpatient care of discharged state hospital and non-hospitalized psychiatric emergency room patients.

The present article compares a cohort discharged from two state hospitals in a large urban area with a cohort referred for outpatient services from a psychiatric emergency room. Both cohorts were referred into the same community mental health system of services. The two cohorts are examined in terms of clinical and social demographic characteristics, in part to consider how distinct the two populations appear to be. In addition, patterns of initial contact and the nature and amounts of community services received by each group are compared. Based on these comparisons, some conclusions are drawn regarding the way in which these two groups are served by the community system.

The differential receipt of rehabilitation services among an aftercare population

This article reports on a study of discharged state psychiatric hospital patients who subsequently received community mental health services. All received standard services, including case management, chemotherapy, emergency services, and group and/or individual therapy. A comparison of those who received both rehabilitation and standard services and those who received only standard services, revealed that blacks were less likely to receive rehabilitation. Nonschizophrenic and substance abusing clients were less likely to receive rehabilitation services. Those clients who received rehabilitation services generally received a greater amount of all types of services.