A STATE MANAGEMENT PLANNING SYSTEM FOR ADDRESSING HIGH-LEVELS OF USE OF INPATIENT PSYCHIATRIC-SERVICES

Research on psychiatric hospital admissions shows that a small group o f patients use a disproportionate amount of inpatient services. In the late 1980s Washington State developed initiatives to target get outpa tient community mental health services to mentally ill persons with hi gh rates of inpatient psychiatric service use. Services to the targete d group are provided by regional support networks under contract with the state. Diverse funding sources were consolidated to give the regio nal authorities flexibility to tailor funding to local needs, and new appropriations were tied to the region's commitment to increase capaci ty for community mental health services. To support those initiatives, the state developed a specialized client-focused database to identify individuals with high rates of hospital utilization, provide informat ion to regional authorities about use of hospital services by those in dividuals, and assess whether they were receiving outpatient services. Analyses of statewide data showed wide variation among regions in hos pital use and delivery of community services.