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Article
Statewide initiative of intensive psychiatric rehabilitation: outcomes and relationship to other mental health service use
Systems and Psychosocial Advances Research Center Publications and Presentations
  • Marsha Langer Ellison, University of Massachusetts Medical School
  • E. Sally Rogers, Boston University
  • Asya Lyass, Boston University
  • Joseph Massaro, Boston University
  • Nancy J. Wewiorski, Bedford VA Medical Center
  • Su-Ting Hsu, Chang Gung University
  • William A. Anthony, Boston University
UMMS Affiliation
Department of Psychiatry, Center for Mental Health Services Research; Center for Health Policy and Research
Date
7-20-2011
Document Type
Article
Medical Subject Headings
Adult; Employment; Female; Humans; Income; Iowa; Male; Managed Care Programs; Mental Disorders; Mental Health Services; Outcome Assessment (Health Care); Residence Characteristics; State Health Plans
Abstract
OBJECTIVE: This study examines the outcomes of a statewide implementation of Intensive Psychiatric Rehabilitation (IPR) for improving residential and employment status and earnings among individuals with severe mental illnesses and also examines its implementation with respect to mental health service utilization and costs. METHODS: This study employs a pre-post design with participants acting as their own controls for rehabilitation outcomes (residential status, vocational outcomes and earnings) comparing those who "completed" or had a sufficiently intense dose of IPR (one year) to those who dropped out early (before six months of service) and those who dropped out later in service (6-12 months). A separate analysis was conducted examining the relationship of IPR to other mental service use and costs using a quasi-experimental design that contrasted IPR completers with a control group matched via propensity scores. RESULTS: The results suggested significant improvement in residential status, employment status and gross monthly earnings for IPR completers relative to other groups. IPR completers also tended to use more mental health services or have more shallow decreases in use and cost of services relative to matched controls. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: Gains in rehabilitation outcomes can be expected for those who engage in and complete IPR services, but IPR cannot be expected to result in reduced overall mental health service use and costs. Rather, IPR may improve service access or perhaps ameliorate any containment effect of managed care on service use.
Rights and Permissions
Citation: Psychiatr Rehabil J. 2011 Summer;35(1):9-19. Link to article on publisher's site
Related Resources
Link to Article in PubMed
Citation Information
Marsha Langer Ellison, E. Sally Rogers, Asya Lyass, Joseph Massaro, et al.. "Statewide initiative of intensive psychiatric rehabilitation: outcomes and relationship to other mental health service use" Vol. 35 Iss. 1 (2011) ISSN: 1095-158X (Linking)
Available at: http://works.bepress.com/marsha_ellison/12/