Lehman A F, Postrado L T, Roth D, McNary S W, Goldman H H
Center for Mental Health Services Research, University of Maryland School of Medicine, Baltimore.
Milbank Q. 1994;72(1):105-22.
The impact on services and outcomes of the local mental health authorities (LMHAs) developed under the RWJF Program on Chronic Mental Illness (CMI) was evaluated in Baltimore, Cincinnati, Columbus, and Toledo. Two cohorts of clients with CMI discharged from an episode of acute 24-hour care were recruited in each city: the first cohorts were drawn shortly after the demonstration began and the second, two years later. The LMHAs in the three Ohio cities increased case management for the second cohorts at two months, but not at 12 months, after hospital discharge. The second cohorts in Baltimore and Cincinnati experienced lower turnover among case managers during the year after discharge, but there was no significant improvement in client outcomes. Creation of LMHAs may be a necessary, but not sufficient, step toward improving outcomes and should be followed by improvement in the quantity and quality of services.
在巴尔的摩、辛辛那提、哥伦布和托莱多，对根据罗伯特·伍德·约翰逊基金会慢性精神疾病项目（CMI）设立的地方心理健康管理机构（LMHA）对服务和结果的影响进行了评估。在每个城市招募了两组因急性24小时护理发作而出院的慢性精神疾病患者：第一组在示范开始后不久招募，第二组在两年后招募。俄亥俄州三个城市的地方心理健康管理机构在出院后两个月增加了对第二组患者的病例管理，但在12个月时没有增加。巴尔的摩和辛辛那提的第二组患者在出院后的一年中病例管理人员的更替率较低，但患者的结果没有显著改善。设立地方心理健康管理机构可能是改善结果的必要步骤，但不是充分步骤，之后应改善服务的数量和质量。
