How to Foster Continuity of Care

From Psychiatric News, May 18, 2007, Volume 42, Number 10, page 19:

The following are recommendations from the National Council for Community Behavioral Healthcare on helping people with serious mental illness continue to receive treatment after their discharge from inpatient care:

• Hospitals and community-based organizations should collaborate more closely with one another. This may include standardization of information and shared electronic health records.


• Providers and mental health organizations should use treatment-performance standards as part of a quality-improvement approach that can enhance treatment continuity.


• All mental health consumers should receive care management for transition from hospital to community; care-management services should be reimbursable by all payers, and the disincentives to providing them should be removed.


• Mental health agencies should focus on the "pull model" of transition from inpatient to outpatient care, which emphasizes involving community-based providers in the transition process.


• Accreditation standards should be aligned to address and improve continuity of therapy in treating mental illness.


• Consumers and their families should be educated about the benefits of maintaining their medical histories, whether through written logs or portable electronic devices.


• Consumer-driven recovery planning should include the appropriate use of hospitalization. More thoughtful use of inpatient services can lead to a reduction in emergency-room use and a decrease in number of hospitalizations.


• Payers who collect data about mental health services and performance should share the data with appropriate stakeholders to enhance the provision of care.


• Consumers and mental health advocates should be involved in all levels of system delivery and evaluation. Examples include using peer specialists as part of a treatment team and involving them in the development and implementation of performance-evaluation measures.