Table of Contents Author Guidelines Submit a Manuscript
Depression Research and Treatment
Volume 2012, Article ID 325249, 10 pages
http://dx.doi.org/10.1155/2012/325249
Research Article

Leading from the Middle: Replication of a Re-Engagement Program for Veterans with Mental Disorders Lost to Follow-Up Care

1VA National Serious Mental Illness Treatment Resource and Evaluation Center and VA Center for Clinical Management Research, VA Ann Arbor Healthcare System, 2215 Fuller Road, Mailstop 152, Ann Arbor, MI 48105, USA
2Department of Psychiatry, University of Michigan Medical School, North Campus Research Complex, 2800 Plymouth Road, Building 14, Ann Arbor, MI 48109-2800, USA
3Mental Health Services, Patient Care Services, Veterans Health Administration, Washington, DC 20420, USA

Received 10 May 2012; Accepted 7 August 2012

Academic Editor: Mark S. Bauer

Copyright © 2012 David E. Goodrich et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objectives. Persons with mental disorders experience functional impairments and premature mortality. Limited continuity of care may contribute to disparities in this group. We describe the replication of an evidence-based outreach program (Re-Engage) to reconnect Veterans with mental disorders into care who have dropped out of services. Methods. Using the Enhanced Replicating Effective Programs framework, population-based registries were used to identify Veterans lost-to-care, and providers used this information to determine Veteran disposition and need for care. Providers recorded Veteran preferences, health status, and care utilization, and formative process data was collected to document implementation efforts. Results. Among Veterans who dropped out of care , the mean age was 49 years, 10% were women, and 29% were African-American. Providers determined that 39% of Veterans identified for re-engagement were deceased, hospitalized, or ineligible for care. Of the remaining 68 Veterans, outreach efforts resulted in contact with 20, with 7 returning to care. Providers averaged 14.2 hours over 4 months conducting re-engagement services and reported that gaining facility leadership support and having service agreements for referrals were essential for program implementation. Conclusions. Population-level, panel management strategies to re-engage Veterans with mental disorders are potentially feasible if practices are identified to facilitate national rollout.