TY - JOUR
T1 - Efficacy of the home-based Mental Health Evaluation (HOME) program for engaging patients in care after hospitalization
AU - Matarazzo, Bridget B.
AU - Forster, Jeri E.
AU - Hostetter, Trisha A.
AU - Billera, Melodi
AU - Adler, Geri
AU - Ganzini, Linda K.
AU - Oslin, David W.
AU - Brenner, Lisa A.
N1 - Funding Information:
Rocky Mountain Mental Illness, Research, Education and Clinical Center (MIRECC), U.S. Department of Veterans Affairs (VA), Aurora, Colorado (Matarazzo, Forster, Hostetter, Billera, Brenner); Department of Psychiatry (Matarazzo), and Department of Physical Medicine and Rehabilitation (Forster, Brenner), University of Colorado School of Medicine, Aurora; South Central MIRECC, VA, Houston, and Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston (Adler); Center to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland, Oregon, and Department of Psychiatry, Oregon Health and Science University, Portland (Ganzini); MIRECC, Veterans Integrated Service Network 4, VA, Philadelphia, and Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Oslin). Send correspondence to Dr. Matarazzo (bridget.matarazzo@va.gov). The data in this report were presented at the following conferences: annual conference of the American Association of Suicidology, Phoenix, April 26–27, 2017; DoD/ VA Suicide Prevention Conference, Denver, August 1–3, 2017; and IASR/ AFSP International Summit on Suicide Research, Henderson, Nevada, November 5–8, 2017. This work was partly supported by the Military Suicide Research Consortium (MSRC), an effort supported by the Office of the Assistant Secretary of Defense for Health Affairs under award W81XWH-10-2-0178 (proposal 09162006). Opinions, interpretations, conclusions, and
Publisher Copyright:
© 2019 American Psychiatric Association. All rights reserved.
PY - 2019
Y1 - 2019
N2 - Objective: The risk of suicide is elevated in the days and weeks after discharge from a psychiatric hospitalization, and lack of treatment engagement posthospitalization is also associated with suicide. The authors sought to determine whether the Home-Based Mental Health Evaluation [HOME] Program is efficacious in helping patients engage in care after psychiatric hospitalization. Methods: This study was a nonrandomized, controlled, two-arm (HOME Program versus enhanced care as usual [E-CARE]) trial that took place at four Department of Veterans Affairs medical centers. Participants (N=302) were patients admitted to a psychiatric inpatient unit. The HOME Program consists of phone- and home-based contacts that include suicide risk assessment, safety planning, and problem-solving around barriers to care. The primary outcome was treatment engagement, as documented in the electronic medical record. Results: Veterans in the HOME Program group were 1.33 (95% confidence interval [CI]=1.29–1.37) times more likely to engage in treatment, compared with veterans in the E-CARE group (p,0.001). HOME Program participants were estimated to have attended 55% more individual appointments (95% CI=12%2113%, p=0.02), compared with those in the E-CARE group. The adjusted difference in median time to treatment engagement was 15 days (95% CI= 3.5–27.0) such that HOME Program participants engaged in treatment more quickly than participants at the E-CARE sites. Conclusions: Findings suggest that participation in the HOME Program can help individuals at high risk of suicide engage in care after psychiatric hospitalization.
AB - Objective: The risk of suicide is elevated in the days and weeks after discharge from a psychiatric hospitalization, and lack of treatment engagement posthospitalization is also associated with suicide. The authors sought to determine whether the Home-Based Mental Health Evaluation [HOME] Program is efficacious in helping patients engage in care after psychiatric hospitalization. Methods: This study was a nonrandomized, controlled, two-arm (HOME Program versus enhanced care as usual [E-CARE]) trial that took place at four Department of Veterans Affairs medical centers. Participants (N=302) were patients admitted to a psychiatric inpatient unit. The HOME Program consists of phone- and home-based contacts that include suicide risk assessment, safety planning, and problem-solving around barriers to care. The primary outcome was treatment engagement, as documented in the electronic medical record. Results: Veterans in the HOME Program group were 1.33 (95% confidence interval [CI]=1.29–1.37) times more likely to engage in treatment, compared with veterans in the E-CARE group (p,0.001). HOME Program participants were estimated to have attended 55% more individual appointments (95% CI=12%2113%, p=0.02), compared with those in the E-CARE group. The adjusted difference in median time to treatment engagement was 15 days (95% CI= 3.5–27.0) such that HOME Program participants engaged in treatment more quickly than participants at the E-CARE sites. Conclusions: Findings suggest that participation in the HOME Program can help individuals at high risk of suicide engage in care after psychiatric hospitalization.
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U2 - 10.1176/appi.ps.201900002
DO - 10.1176/appi.ps.201900002
M3 - Article
C2 - 31451065
AN - SCOPUS:85075960573
SN - 1075-2730
VL - 70
SP - 1094
EP - 1100
JO - Hospital and Community Psychiatry
JF - Hospital and Community Psychiatry
IS - 12
ER -