Client outcomes: II. Longitudinal client data from the Colorado Treatment Outcome Study

New York State Office of Mental Health, Albany.
Milbank Quarterly (Impact Factor: 5.06). 02/1994; 72(1):123-48. DOI: 10.2307/3350341
Source: PubMed

ABSTRACT The outcomes of a reform of the Denver mental health system, cosponsored by the state and the RWJF, are contrasted with changes in a comparison area of the state. The study examines the structural characteristics of the mental health system, staff attitudes and satisfaction, and client-reported services and outcome. Results indicate that, in Denver, structural changes, the introduction of new services, and an intervening financial crisis increased worker dissatisfaction. Client reports documented parallel changes in the following variables: continuity of care, unmet need for case management services, frequency of symptoms, and satisfaction with services. The reform had no impact, however, on most quality-of-life indicators. The possibly adverse consequences of centralizing the system and the indirect influences of system integration on quality of life are discussed.

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    • "Index (CSI). The CSI (Shern et al., 1994) was used to measure psychiatric symptoms and is consistent with the National Institute of Mental Health task force criteria for outcome measures (Ciarlo, Edwards, Kiresuk, et al., 1981). Although two versions of the CSI exist, the version reported on in this article is the 14-item version. "
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    ABSTRACT: The purpose of this study was to examine the prevalence of self-perceived oral health needs among Medicaid-enrolled adults with and without mental health problems and to identify factors predictive of enrollees' perceived oral health needs. The study involved a secondary analysis of 1,721 respondents to the Florida Health Services Survey. Contrary to the previous research, the findings from this study indicated that respondents with mental health problems (52.9%) did not differ significantly in their dental needs compared to those who did not have mental health problems (49.3%). The results from a logistic regression suggested that after controlling for demographic characteristics, substance abuse problems and functional needs increased the likelihood of self-reported oral health needs, whereas the receipt of Supplemental Security Income (SSI) was associated with decreased dental needs. The prevalence of unmet dental needs among these respondents (i.e., 23%) supported the conclusion that a significant gap exists in the accessibility of oral health services among this population.
    Evaluation &amp the Health Professions 06/2014; 38(1). DOI:10.1177/0163278714537271 · 1.67 Impact Factor
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    • "Current psychiatric symptomatology was assessed using the Colorado Symptom Index (CSI; Shern et al., 1994). This widely used self-report measure assesses the frequency of psychiatric symptoms in the past month. "
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    ABSTRACT: The purpose of this study was to extend the investigation of criminal thinking of persons with mental illness beyond prison and community settings to a jail setting. Participants consisted of 122 individuals incarcerated in a county jail who were diagnosed with a severe mental illness, including schizophrenia spectrum and major mood disorders. Results indicated that people with mental illness in this sample of jail inmates presented with thinking styles that support a criminal lifestyle, and have criminal thinking styles that follow a pattern that is very similar to a sample of prison inmates with serious mental illness. These findings support the need for therapeutic programs for justice-involved persons with serious mental illness to develop a multipronged treatment approach that integrates interventions for individuals' criminal thinking and antisocial attitudes with treatment for their mental illness and substance abuse issues. (PsycINFO Database Record (c) 2014 APA, all rights reserved).
    Law and Human Behavior 04/2014; 38(6). DOI:10.1037/lhb0000084 · 2.16 Impact Factor
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    • "Information about prescribed medications was obtained from chart review. The Colorado Symptom Index (CSI) (Shern et al., 1994) was used to assess anxiety and depression symptoms (higher scores reflecting more frequent symptoms). "
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    ABSTRACT: Persons with serious mental illness (SMI) have higher rates of chronic medical conditions such as type 2 diabetes and mortality than the general population. We assessed demographic and health related factors in the prediction of all-cause mortality among SMI patients with diabetes and a comparison group of diabetic patients without SMI. From 1999 to 2002, 201 patients with type 2 diabetes and SMI were recruited from community mental health centers and 99 persons with type 2 diabetes and no identified mental illness were recruited from nearby primary clinics. Deaths over an average seven-year period after baseline assessment were identified using the Social Security Administration's Death Master File. Twenty-one percent in each group died over follow-up. Age, smoking status, duration of diabetes, and diabetes-related hospitalization in the 6months prior to baseline assessment predicted mortality in all patients. Among the non-SMI patients, those who were prescribed insulin had over a four-fold greater odds of mortality whereas this association was not found in the SMI patients. Diabetes likely contributes to mortality in persons with SMI. Providers need to be especially vigilant regarding mortality risk when patients require hospitalization for diabetes and as their patients age. Smoking cessation should also be aggressively promoted.
    Psychiatry Research 02/2010; 177(1-2):250-4. DOI:10.1016/j.psychres.2010.01.004 · 2.68 Impact Factor
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