SMI AND OUTCOME OF MANDATED SERVICES

SMI 和授权服务的结果

• 批准号: 6165204
• 负责人: Jeffrey Draine
• 金额: $ 29.84万
• 依托单位: UNIVERSITY OF PENNSYLVANIA
• 依托单位国家: 美国
• 财政年份: 1998
• 资助国家: 美国
• 起止时间: 1998-03-15 至 2002-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6165204
• 关键词: behavioral /social science research tag; clinical research; community mental health services; health care policy; health care service evaluation; health care service utilization; health related legal; health services research tag; human subject; human therapy evaluation; mental disorders; outcomes research; outpatient care; psychiatric patient care; psychosocial rehabilitation; quality of life; rehabilitation; relapse /recurrence; statistics /biometry; therapy compliance

DESCRIPTION (Applicant's Abstract): Some have clinically justified mandated treatment mechanisms for persons with serious mental illness (SMI) on the basis that persons with SMI benefit from mandated care because coercion compensates for psychosocial deficits. However, services research on systematic coercive measures, such as outpatient commitment, has not examined this assumption. The Investigators propose a prospective naturalistic study of formal mandates to receive community mental health services. Mandates to comply with treatment are found in outpatient commitment, probation and parole, housing services, child protection services, substance abuse treatment, crisis services, and homeless services (Mulvey, Geller, & Roth, 1987). These formal mandates can vary in nature and intensity. However, ambiguity about the extent to which such mandates result in receipt of effective services confounds interpretation of research on policies such as outpatient commitment, intensive case management or intensive probation for persons with mental illness. Attribution of client outcomes, such as reduced hospital recidivism, to service mandates has been hampered by the vague treatment of potentially important variables such as perceived and objective coercion, working alliance with enforcing clinicians, and serious mental illness (SMI) (Draine, in press; Maloy, 1996). A sample of 250 individuals will be followed from acute inpatient hospitalization, through 90 day commitments to aftercare, and 90 days after the termination of the commitment period to test an outcome model of coercion in the context of mandated services.

描述（申请人的摘要）：一些具有临床合理性规定 严重精神疾病（SMI）患者的治疗机制 SMI 患者受益于强制护理的依据是因为胁迫 补偿心理社会缺陷。 然而，服务业研究 系统性强制措施，例如门诊承诺，尚未 检查了这个假设。 研究人员提出了一个前瞻性的 对接受社区心理健康的正式任务的自然主义研究 服务。 门诊病人必须遵守治疗规定 承诺、缓刑和假释、住房服务、儿童保护 服务、药物滥用治疗、危机服务和无家可归者服务 （穆尔维、盖勒和罗斯，1987）。 这些正式授权的性质可能有所不同 和强度。 然而，此类授权的范围尚不明确 获得有效服务的结果混淆了研究的解释 门诊承诺、强化病例管理或 对患有精神疾病的人实行强化缓刑。 客户归属 成果，例如减少医院累犯，以服务任务 由于对潜在重要变量的模糊处理而受到阻碍，例如 感知到的和客观的胁迫，与执法者结盟 临床医生和严重精神疾病 (SMI)（Draine，出版中；Maloy， 1996）。 将从急性住院患者中抽取 250 名个体作为样本进行追踪 住院治疗，通过 90 天的善后护理承诺，以及 90 天后 测试结果模型的承诺期终止 强制服务中的胁迫。