HEAVY UTILIZATION OF INPATIENT AND OUTPATIENT SERVICES IN A PUBLIC MENTAL-HEALTH-SERVICE

Objective: The purpose of the study uas to develop a descriptive profi le of heavy users of services in the South Australian Mental Health Se rvices. Methods: Case notes for 50 heavy users were reviewed to obtain demographic and diagnostic infomration and data on service use over a three-year period. To supplement and verify this information, 35 of t he patients were given structured interviews. Results: The mean age of the 50 patients was 34.9 years, and there was a slight predominance o f females. Most patients had never married and had been unemployed for a long time. All had a low income. The mean number of years of educat ion was ten. The group was seriously disabled by psychiatric illness. The most common diagnosis was schizophrenia, followed by schizoaffecti ve disorder and bipolar disorder. Comorbid axis I disorder and persona lity disorder or physical illness was common. Drug and alcohol abuse o ften complicated patient management and patients' ability to live succ essfully in the community. The average annual cost per patient was $13 ,598 (Australian), largely from inpatient care. Conclusions: This stud y contributes to an emerging global profile of the heavy service user. Such a profile may help service systems identify patients in this sub group and target management strategies to these often very disadvantag ed and challenging patients.