Psychiatric home health: the newest kid on the block.

What is psychiatric home health care? Psychiatric home health care is a clinical specialty of home health services in which psychiatric nurses, social workers, home health aides, and occupational therapists visit the patient with a primary psychiatric diagnosis in the patient's own home. This service has been acknowledged in the Home Health Agency Manual for at least a decade but only recently has received widespread attention from home health providers. In fact, beginning in May 1996, the Health Care Financing Administration has broadened the service capacity by allowing all physicians, not just psychiatrists, to sign a Medicare psychiatric plan of care. This new standard is consistent with already recognized trends of primary care physicians treating psychiatric patients. The mental health literature is increasingly giving recognition to alternatives to traditional continuum of care models that favor psychiatric hospitalization. Addition of in-home interventions to psychiatric delivery systems has resulted in significant reduction in both hospitalization admission and recidivism rates. The models tested have, unfortunately, not used psychiatric home health care, but as more awareness and programs come into existence, psychiatric home health care can play a significant role in the mental health delivery system, particularly in a managed care environment.