Many privately insured youth and young adults seen in emergency rooms or hospitalized for psychiatric conditions are not receiving recommended follow-up care in the month following hospital discharge, suggests a report published yesterday in Psychiatric Services.
“Follow-ups with a mental health care provider within 7 and 30 days are national quality measures associated with improved medication adherence, decreased suicide risk, and increased long-term health care engagement,” wrote Julie Hugunin, B.S., and Maryann Davis, Ph.D., of the University of Massachusetts Chan Medical School and colleagues.
Hugunin, Davis, and colleagues used data collected between 2013 and 2018 in the IBM MarketScan commercial database to identify people aged 12 to 27 with a mental health hospitalization (n=95,153) or emergency room (ER) visit (n=108,576). Both samples included youth and young adults who had what the authors defined as an “acute event stemming from a mental health condition.” The authors then looked at whether the participants had received outpatient mental health care or primary care follow-ups within 7 and 30 days of discharge from the hospital. They also looked at whether having sought outpatient primary and/or mental health care in the six months prior to hospitalization impacted follow-up care.
The most common primary diagnosis for hospitalized patients was major depression (54%), followed by bipolar disorder (22%); self-harm, suicidal ideation, or suicide attempt was coded on 57% of hospitalizations. The most common primary diagnosis for ER patients were anxiety disorders/phobias (44%), followed by major depression (23%); self-harm, suicidal ideation, or suicide attempt was coded on 25% of these visits
The researchers found that nearly 43% of those in the hospitalized group received follow-up within 7 days and 68% within 30 days. In the ER group, nearly 29% received follow-up within 7 days and 46% within 30 days.
“The strongest predictor of mental health follow-up was established outpatient care,” wrote Hugunin, Davis, and colleagues. Compared with people with no established care, the likelihood of receiving follow-up within 7 days was highest among those with mental health care and primary care, followed by those with mental health care only and those with primary care only, they added. Similar trends were observed within 30 days of discharge.
The study by Hugunin, Davis, and colleagues was released ahead of APA’s Mental Health Services Conference, which kicks off today in Washington, D.C. See future issues of Psychiatric News for coverage of this meeting.
(Image: iStock/MJFelt)
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