Polgar M F, Johnsen M C, Starrett B E, Fried B J, Morrissey J P
Washington University, St. Louis, MO, USA.
J Health Hum Serv Adm. 2000 Summer;23(1):50-64.
North Carolina has developed coordinated care systems for people dually diagnosed with both a mental retardation and a different major mental illness. In response to a class action lawsuit, the state has become a leader in treatment of this form of dual diagnosis. Systems of care for this "Thomas S class" operate in each of 41 area programs for mental health, developmental disabilities, and substance abuse. Networks of care among leaders in mental health and developmental disability promote the coordination of health, housing, social, and vocational services. A survey of 100 area program leaders finds extensive cooperation and a variety of services provided and contracted for, both within and beyond each area program, particularly among developmental disability specialists. Cooperation among leaders is associated with service variety and inter-organizational linkages. The extent of relationships among provider organizations is associated with better access to care. Best practice includes a single portal of entry and inter-agency councils.
北卡罗来纳州已为同时患有智力障碍和另一种主要精神疾病的人群建立了协调护理系统。作为对一起集体诉讼的回应，该州已成为这种双重诊断形式治疗方面的领导者。针对这种“托马斯S类”人群的护理系统在41个心理健康、发育障碍和药物滥用领域项目中均有运作。心理健康和发育障碍领域的领导者之间的护理网络促进了健康、住房、社会和职业服务的协调。对100名领域项目领导者的调查发现，存在广泛的合作，并且在每个领域项目内部和外部都提供并签约了各种服务，尤其是在发育障碍专家之间。领导者之间的合作与服务多样性及组织间联系相关。提供者组织之间关系的程度与更好的医疗服务可及性相关。最佳实践包括单一的入口门户和跨机构委员会。
