Article Figures & Data
Tables
Assistance Control Intervention Assistance with health care insurance application x x Provision of peer support x x Information on primary care sites that are federally funded or have sliding fee scales x x Provision of care manager x Assistance with making primary care appointments x Assistance with attending primary care appointments x Identification of travel routes and public transportation options x Patient education; reinforcement of teaching from primary care x Ongoing follow-up, including home visits and mobile outreach x Coordination with mental health peers to support connections with community mental health care x How would you describe your current health status in general (ie, body, mind, and soul)?
Where do you usually go and whom do you see to get care for your health and wellness concerns? Please describe.
How would you describe your experiences (good and/or bad ones) in trying to get the health care you need for both your medical and mental health concerns?
What do you think are the main problems with trying to get the health care you need for both your medical and mental health concerns?
What does or would it mean to you to have (a) a regular medical doctor? (b) a regular medical doctor who consults with your mental health care professional?
- Table 3.
Characteristics of Study Patients (Intervention and Control) at Baseline (N = 56)
Characteristic No. (%) Note: Some patient data are missing for those variables where the the totals are less than 56. GED = general equivalency diploma. Sex Male 38 (67.9) Female 18 (32.1) Age, years <30 16 (28.6) 30–39 12 (21.4) 40–49 15 (26.8) ≥50 13 (23.2) Race/ethnicity African American 21 (37.5) White 27 (48.2) American Indian 1 (1.8) Latino 2 (3.6) Other 5 (8.9) Employment Full time 5 (9.3) Self-employed 1 (1.9) Part time 13 (24.1) Unemployed 35 (64.8) Annual household income <$5,000 28 (52.8) $5,000-$9,999 15 (28.3) $10,000-$20,000 7 (13.2) >$20,000 3 (5.7) Education 8th grade or less 4 (7.1) Some high school 14 (25.0) High school graduate/GED degree 23 (41.1) Some college or more 15 (26.8) Been homeless 16 (29.0) Mental health disorder Mood disorder 21 (37.5) Adjustment disorder 8 (14.3) Psychotic disorder 22 (39.3) Substance use disorder 26 (46.4) Dual diagnosis 21 (37.5)
Additional Files
The Article in Brief
Primary Care After Psychiatric Crisis: A Qualitative Analysis
Kim S. Griswold, MD, MPH , and colleagues
Background Primary care is of value to patients with mental health conditions, but getting connected to a primary care doctor may be difficult for patients with serious mental illness who are emerging from psychiatric crisis. The goals of this study were (1) to determine whether care managers (who coordinate medical care and link patients to necessary resources) improve patients' access to primary care, and (2) to understand patients' experiences with health care after a psychiatric crisis.
What This Study Found Among patients who have experienced a psychiatric crisis, those assigned a care manager have easier access to primary care and feel it is of benefit to them compared with those who are not. Seventy-one percent of those with a care manager report that having someone to assist them in making primary care connections is beneficial. Additionally, at 6 months, patients with a care manager report better physical and mental function than their counterparts. At 1 year, however, differences in physical function are no longer significant.
Implications
- Care management is effective in helping patients gain access to primary care after a psychiatric crisis and, for some, it makes the difference between finding a regular doctor or going without care.
