Mental Health and Substance Abuse patients at high risk of being readmitted into hospitals.

In 2009, researchers discovered that substance abuse and mental health services cost the United States $172 billion every year (Santora, Smith & Stocks, 2015). The readmission of patients who suffered from mental health and substance abuse (MHSA) proved to be very expensive. Identifying the reasons behind why these patients required repeat visits is essential to preventing readmissions and reducing costs (Santora, Smith & Stocks, 2015). The study found that high readmission rates and emergency department (ED) visits can be attributed to not having access to proper care and not being directed to the proper resources once patients leave the hospital (Santora, Smith & Stocks). Identifying high-utilizing MHSA patients early-on would help provide guidance for outpatient planning and coordination efforts to help meet the treatment needs of MHSA patients to reduce their readmission rates to the emergency department and improve their overall health (Santora, Smith & Stocks, 2015).

The study by Santora, Smith and Stocks found that after one year of being discharged as an inpatient, 30% of patients who suffer from MHSA were readmitted to the hospital. The patients with the greatest chance of being readmitted to the hospital or ED were those who were schizophrenic or had an alcohol dependence (Santora, Smith & Stocks, 2015). Drug dependence, dementia, autism, psychotic disorders, impulse control disorders and personality disorders were also at high risk of being readmitted to the hospital (Santora, Smith & Stocks, 2015). The study that Santora, Smith & Stocks conducted showed similar results to the study done by Klinkenberg and Calsyn in 1990 where they found a 35% readmission rate for MHSA patients (Santora, Smith & Stocks, 2015).

The World Health Organization (WHO) found that social, economic and environmental circumstances all play a role in an individual developing a mental health disorder (World Health Organization & Calouste Gulbenkian Foundation, 2014). Actions taken to help mitigate social inequalities will help to improve overall population health and reduce costs. “There is a considerable need to raise the political, and strategic priority to the prevention of mental disorders and to the promotion of mental health through action on the social determinants of health” (World Health Organization & Calouste Gulbenkian Foundation, 2014, p. 12). The information presented demonstrates that using social determinants of health data is one way that clinicians can help identify high-utilizing patients early and provide better care. The WHO also found that primary care plays a major role in being able to address mental disorders early on in order to prevent readmission into hospitals and repeat episodes. With early identification, primary care clinicians are then able to promote good mental health by referring patients directly to specialized services outside the hospital (World Health Organization & Calouste Gulbenkian Foundation, 2014).

Overall, the efforts taken to address the gaps in identifying who MHSA patients are early on will improve outcomes and decrease costs to the health care system (Santora, Smith & Stocks, 2015).

References:

Santora, P. B., Smith, M. W., & Stocks, C. (2015). Hospital Readmission Rates and Emergency Department Visits for Mental Health and Substance Abuse Conditions. Community Mental Health Journal, 51, 190-197. Retrieved from https://journals-scholarsportal-info.libaccess.lib.mcmaster.ca/pdf/00103853/v51i0002/190_hrraedmhasac.xml

World Health Organization & Calouste Gulbenkian Foundation. (2014). Social determinants of mental health. Geneva. Retrieved from http://apps.who.int/iris/bitstream/handle/10665/112828/9789?sequence=1

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