Skip to main content
Erschienen in: Social Psychiatry and Psychiatric Epidemiology 1/2021

02.01.2020 | Original Paper

Identifying profiles of need among psychiatric inpatients approaching discharge in New York City: a latent class analysis

verfasst von: Kate L. McDonald, Jennifer M. Hoenig, Christina C. Norman

Erschienen in: Social Psychiatry and Psychiatric Epidemiology | Ausgabe 1/2021

Einloggen, um Zugang zu erhalten

Abstract

Purpose

Understanding the needs of individuals transitioning to the community following a psychiatric hospitalization can inform community service planning. This study is among the first to examine the needs of a sample of psychiatric inpatients approaching discharge in a large urban area in the USA.

Methods

Representative data were drawn from 1129 acutely hospitalized psychiatric inpatients from eight New York City hospitals. Descriptive statistics were used to estimate patient needs at discharge across nine domains: housing, employment, income, transportation, education, time use, social support, and help accessing medical and mental health care. Latent class analysis (LCA) was applied to identify subgroups of patients based on needs profiles. Multinomial logistic regression was used to investigate socio-demographic associations with class membership.

Results

Respondents were most likely to have needs related to income (50.7%), housing (49.2%), and employment (48.7%). Results from the LCA suggested a five class solution of patient needs: three domain-specific classes whose members endorsed needs for ‘housing and employment’ (22.5%), ‘social support and time use’ (15.0%) and ‘access to care’ (6.4%) and two classes where overall member needs were high (‘high needs,’18.4%) or low (‘low needs,’ 37.7%) across all needs. Compared to the ‘low needs’ class, members of the ‘high needs’ class had significantly greater odds of being black or Latino, male, uninsured, and parents of a child under 18 years.

Conclusion

Patients have unique profiles of need that are significantly associated with the socio-demographic characteristics. These findings may help practitioners and policymakers improve mental health services.
Literatur
1.
Zurück zum Zitat Wojas E, Meausoone V, Norman C (2016) Adult psychiatric hospitalizations in New York City. Dep Health Mental Hygiene 71:1–6 Wojas E, Meausoone V, Norman C (2016) Adult psychiatric hospitalizations in New York City. Dep Health Mental Hygiene 71:1–6
2.
Zurück zum Zitat Culhane D, Metraux S, Hadley T (2002) Public service reductions associated with placement of homeless persons with severe mental illness in supportive housing. Hous Policy Debates 13(1):107–163CrossRef Culhane D, Metraux S, Hadley T (2002) Public service reductions associated with placement of homeless persons with severe mental illness in supportive housing. Hous Policy Debates 13(1):107–163CrossRef
3.
Zurück zum Zitat Green CA, Estroff SE, Yarborough BJ, Spofford M, Solloway MR, Kitson PS, Perrin NA (2014) Directions for future patient-centered and comparative effectiveness research for people with serious mental illness in a learning mental health care system. Schizophr Bull 40(1):S1–S94CrossRef Green CA, Estroff SE, Yarborough BJ, Spofford M, Solloway MR, Kitson PS, Perrin NA (2014) Directions for future patient-centered and comparative effectiveness research for people with serious mental illness in a learning mental health care system. Schizophr Bull 40(1):S1–S94CrossRef
4.
Zurück zum Zitat Kreyenbuhl J, Buchanan RW, Dickerson FB, Dixon LB (2010) The schizophrenia patient outcomes research team (PORT): updated treatment recommendations 2009. Schizophr Bull 36(1):94–103CrossRef Kreyenbuhl J, Buchanan RW, Dickerson FB, Dixon LB (2010) The schizophrenia patient outcomes research team (PORT): updated treatment recommendations 2009. Schizophr Bull 36(1):94–103CrossRef
5.
Zurück zum Zitat Sfetcu R, Musat S, Haaramo P, Ciutan M, Scintee G, Vladescu C, Wahlneck K, Katscgni H (2017) Overview of post-discharge predictors for psychiatric re-hospitalisations: a systematic review of the literature. BMC Psychiatry 17(1):227CrossRef Sfetcu R, Musat S, Haaramo P, Ciutan M, Scintee G, Vladescu C, Wahlneck K, Katscgni H (2017) Overview of post-discharge predictors for psychiatric re-hospitalisations: a systematic review of the literature. BMC Psychiatry 17(1):227CrossRef
6.
Zurück zum Zitat Slade M, Leese M, Cahill S, Thornicroft G, Kuipers E (2005) Patient-related mental health needs and quality of life improvement. Br J Psychiatry 187:256–261CrossRef Slade M, Leese M, Cahill S, Thornicroft G, Kuipers E (2005) Patient-related mental health needs and quality of life improvement. Br J Psychiatry 187:256–261CrossRef
7.
Zurück zum Zitat McCrone PS, Strathdee G (1994) Needs not diagnosis: towards a more rational approach to community mental health resourcing in Great Britain. Int J Soc Psych 40(2):79–86CrossRef McCrone PS, Strathdee G (1994) Needs not diagnosis: towards a more rational approach to community mental health resourcing in Great Britain. Int J Soc Psych 40(2):79–86CrossRef
8.
Zurück zum Zitat Joska J, Flisher AJ (2005) The assessment of need for mental health services. Soc Psychiatry Psychiatr Epidemiol 40(7):529–539CrossRef Joska J, Flisher AJ (2005) The assessment of need for mental health services. Soc Psychiatry Psychiatr Epidemiol 40(7):529–539CrossRef
9.
Zurück zum Zitat McGuire TG, Miranda J (2008) Racial and ethnic disparities in mental health care: evidence and policy implications. Health Aff 27(2):393–403CrossRef McGuire TG, Miranda J (2008) Racial and ethnic disparities in mental health care: evidence and policy implications. Health Aff 27(2):393–403CrossRef
10.
Zurück zum Zitat Roll JM, Kennedy J, Tran M, Howell D (2013) Disparities in unmet need for mental health service in the United States, 1997–2010. Psychiatr Serv 64(1):80–82CrossRef Roll JM, Kennedy J, Tran M, Howell D (2013) Disparities in unmet need for mental health service in the United States, 1997–2010. Psychiatr Serv 64(1):80–82CrossRef
11.
Zurück zum Zitat Meadows G, Burgess P, Bobevski I, Fossey E, Harvey C, Liaw ST (2002) Perceived need for mental health care: influences of diagnosis, demography and disability. Psychol Med 32(2):299–309CrossRef Meadows G, Burgess P, Bobevski I, Fossey E, Harvey C, Liaw ST (2002) Perceived need for mental health care: influences of diagnosis, demography and disability. Psychol Med 32(2):299–309CrossRef
12.
Zurück zum Zitat Bijl RV, Ravelli A (2000) Psychiatric morbidity, service use, and need for care in the general population: results of the Netherlands mental health survey and incidence study. Am J Public Health 90(4):602–607CrossRef Bijl RV, Ravelli A (2000) Psychiatric morbidity, service use, and need for care in the general population: results of the Netherlands mental health survey and incidence study. Am J Public Health 90(4):602–607CrossRef
13.
Zurück zum Zitat Lin E, Goering P, Offord DR, Campbell D, Boyle MH (1996) The use of mental health services in Ontario: epidemiologic findings. Can J Psychiatr 41(9):572–577CrossRef Lin E, Goering P, Offord DR, Campbell D, Boyle MH (1996) The use of mental health services in Ontario: epidemiologic findings. Can J Psychiatr 41(9):572–577CrossRef
14.
Zurück zum Zitat Lefebre J, Cyr M, Lesage A, Fournier L, Toupin J (2000) Unmet needs in the community: can existing services meet them. Acta Psychiatr Scand 102(1):65–70CrossRef Lefebre J, Cyr M, Lesage A, Fournier L, Toupin J (2000) Unmet needs in the community: can existing services meet them. Acta Psychiatr Scand 102(1):65–70CrossRef
15.
Zurück zum Zitat McAlpine DD, Mechanic D (2000) Utilization of specialty mental health care among persons with severe mental illness: the roles of demographics, need, insurance, and risk. Health Serv Res 35(1):277–292PubMedPubMedCentral McAlpine DD, Mechanic D (2000) Utilization of specialty mental health care among persons with severe mental illness: the roles of demographics, need, insurance, and risk. Health Serv Res 35(1):277–292PubMedPubMedCentral
16.
Zurück zum Zitat Simons L, Petch A (2002) Needs assessment and discharge: a Scottish perspective. J Psychiatr Ment Health Nurs 9(4):435–445CrossRef Simons L, Petch A (2002) Needs assessment and discharge: a Scottish perspective. J Psychiatr Ment Health Nurs 9(4):435–445CrossRef
17.
Zurück zum Zitat Norman CC, McDonald K, Schneider AE, Malinovsky I, Goldmann E, Blauschild MK, Driver C (2018) The New York City mental health needs assessment study (MHNAS): objectives, design, and methods. Int J Methods Psychiatr Res 27(2):e1606CrossRef Norman CC, McDonald K, Schneider AE, Malinovsky I, Goldmann E, Blauschild MK, Driver C (2018) The New York City mental health needs assessment study (MHNAS): objectives, design, and methods. Int J Methods Psychiatr Res 27(2):e1606CrossRef
19.
Zurück zum Zitat Phelan M, Slade M, Thornicroft G, Dunn G, Holloway F, Wykes T, Hawyard P (1995) The camberwell assessment of need: the validity and reliability of an instrument to assess the need of people with severe mental illness. BJ Psych 167(5):589–595CrossRef Phelan M, Slade M, Thornicroft G, Dunn G, Holloway F, Wykes T, Hawyard P (1995) The camberwell assessment of need: the validity and reliability of an instrument to assess the need of people with severe mental illness. BJ Psych 167(5):589–595CrossRef
20.
Zurück zum Zitat Meadows G, Burgess P, Fossey E, Harvey C (2000) Perceived need for mental health care, findings from the Australian national survey of mental health and well-being. Psychol Med 30(3):645–656CrossRef Meadows G, Burgess P, Fossey E, Harvey C (2000) Perceived need for mental health care, findings from the Australian national survey of mental health and well-being. Psychol Med 30(3):645–656CrossRef
21.
Zurück zum Zitat Brewin CR, Wing JK, Mangen SP, Brugha TS, MacCarthy B (1987) Principles and practice of measuring needs in the long-term mentally ill: the MRC needs for care assessment. Psychol Med 17(4):971–981CrossRef Brewin CR, Wing JK, Mangen SP, Brugha TS, MacCarthy B (1987) Principles and practice of measuring needs in the long-term mentally ill: the MRC needs for care assessment. Psychol Med 17(4):971–981CrossRef
22.
Zurück zum Zitat Aidala AA, Lee G, Abramson DM, Messeri P, Siegler A (2007) Housing need, housing assistance, and connection to HIV medical care. AIDS Behav 11(6):S101–S115CrossRef Aidala AA, Lee G, Abramson DM, Messeri P, Siegler A (2007) Housing need, housing assistance, and connection to HIV medical care. AIDS Behav 11(6):S101–S115CrossRef
23.
Zurück zum Zitat Andridge RR, Little RJA (2010) A review of hot deck imputation for survey non-response. Int Stat Rev 78(1):40–64CrossRef Andridge RR, Little RJA (2010) A review of hot deck imputation for survey non-response. Int Stat Rev 78(1):40–64CrossRef
24.
Zurück zum Zitat Lanza ST, Collins LM, Lemmon DR, Schafer JL (2007) PROC LCA: a SAS procedure for latent class analysis. Struct Equ Model 14(4):671–694CrossRef Lanza ST, Collins LM, Lemmon DR, Schafer JL (2007) PROC LCA: a SAS procedure for latent class analysis. Struct Equ Model 14(4):671–694CrossRef
25.
Zurück zum Zitat Lanza ST, Dziak JJ, Huang L, Wagner AT, Collins LM (2015) Proc LCA & Proc LTA users’ guide (Version 1.3.2). University Park: the methodology center, Penn State. http://methodology.psu.edu. Accessed 18 June 2019 Lanza ST, Dziak JJ, Huang L, Wagner AT, Collins LM (2015) Proc LCA & Proc LTA users’ guide (Version 1.3.2). University Park: the methodology center, Penn State. http://​methodology.​psu.​edu. Accessed 18 June 2019
26.
Zurück zum Zitat Dean N, Raftery AE (2008) Latent class analysis variable selection. Ann Inst Stat Math 21:11–35 Dean N, Raftery AE (2008) Latent class analysis variable selection. Ann Inst Stat Math 21:11–35
27.
Zurück zum Zitat Castillo EG, Pincus HA, Smith TE, Miller G, Fish DG (2017) New York State medicaid reforms: opportunities and to improve the health of those with serious mental illness. J Health Care Poor Underserved 28(3):839–852CrossRef Castillo EG, Pincus HA, Smith TE, Miller G, Fish DG (2017) New York State medicaid reforms: opportunities and to improve the health of those with serious mental illness. J Health Care Poor Underserved 28(3):839–852CrossRef
28.
Zurück zum Zitat Newman SJ (2001) Housing attributes and serious mental illness: implications for research and practice. Psychiatr Serv 52(10):1309–1317CrossRef Newman SJ (2001) Housing attributes and serious mental illness: implications for research and practice. Psychiatr Serv 52(10):1309–1317CrossRef
29.
Zurück zum Zitat Dickey B, Gonzalez O, Latimer E, Powers K, Schutt R, Goldfiner S (1996) Use of mental health services by formerly homeless adults residing in group and independent housing. Psychiatr Serv 47(2):152–158CrossRef Dickey B, Gonzalez O, Latimer E, Powers K, Schutt R, Goldfiner S (1996) Use of mental health services by formerly homeless adults residing in group and independent housing. Psychiatr Serv 47(2):152–158CrossRef
30.
Zurück zum Zitat Curtis S, Copeland A, Fagg J, Congdon P, Almog M, Fitzpatrick J (2006) The ecological relationship between deprivation, social isolations and rates of hospital admission for acute psychiatric care: a comparison of London and New York City. Health Place 12(1):19–37CrossRef Curtis S, Copeland A, Fagg J, Congdon P, Almog M, Fitzpatrick J (2006) The ecological relationship between deprivation, social isolations and rates of hospital admission for acute psychiatric care: a comparison of London and New York City. Health Place 12(1):19–37CrossRef
31.
Zurück zum Zitat Koppel S, McGuffin P (1999) Socio-economic factors that predict psychiatric admissions at a local level. Pyschol Med 29(5):1235–1241CrossRef Koppel S, McGuffin P (1999) Socio-economic factors that predict psychiatric admissions at a local level. Pyschol Med 29(5):1235–1241CrossRef
32.
Zurück zum Zitat Slade M, Leese M, Taylor R, Thornicroft G (1999) The association between needs and quality of life in epidemiologically representative sample of patients with psychosis. Acta Psychiatr Scan 100(2):149–157CrossRef Slade M, Leese M, Taylor R, Thornicroft G (1999) The association between needs and quality of life in epidemiologically representative sample of patients with psychosis. Acta Psychiatr Scan 100(2):149–157CrossRef
33.
Zurück zum Zitat Bond GR, Resnick SG, Drake RE, Xi H, McHuo GJ, Bebout RR (2001) Does competitive employment improve nonvocational outcomes for people with severe mental illness. J Consult Clin Psychol 69(3):489–501CrossRef Bond GR, Resnick SG, Drake RE, Xi H, McHuo GJ, Bebout RR (2001) Does competitive employment improve nonvocational outcomes for people with severe mental illness. J Consult Clin Psychol 69(3):489–501CrossRef
34.
Zurück zum Zitat Burns T, Catty J, White S, Becker T, Koletsi M, Fioritti A, Rossler W, Tomov T, Busschbach J, Wiersma D, Lauber C (2009) The impact of supported employment and working on clinical and social functioning: results of an international study of individual placement and support. Schizophr Bull 35(5):949–958CrossRef Burns T, Catty J, White S, Becker T, Koletsi M, Fioritti A, Rossler W, Tomov T, Busschbach J, Wiersma D, Lauber C (2009) The impact of supported employment and working on clinical and social functioning: results of an international study of individual placement and support. Schizophr Bull 35(5):949–958CrossRef
35.
Zurück zum Zitat Bond GR (2004) Supported employment: evidence for an evidence-based practice. Psychiatric Rehabil J27(4):345–359CrossRef Bond GR (2004) Supported employment: evidence for an evidence-based practice. Psychiatric Rehabil J27(4):345–359CrossRef
36.
Zurück zum Zitat Newlin M, Webber M, Morris D, Howarth S (2015) Social participation interventions for adults with mental health problems: a review and narrative synthesis. Soc Work Res 39(3):167–180CrossRef Newlin M, Webber M, Morris D, Howarth S (2015) Social participation interventions for adults with mental health problems: a review and narrative synthesis. Soc Work Res 39(3):167–180CrossRef
37.
Zurück zum Zitat Ahn S, Kim S, Zhang H (2016) Changes in depressive symptoms among older adults with multiple chronic conditions: role of positive and negative social support. Int J Environ Res Public Health 14(1):16CrossRef Ahn S, Kim S, Zhang H (2016) Changes in depressive symptoms among older adults with multiple chronic conditions: role of positive and negative social support. Int J Environ Res Public Health 14(1):16CrossRef
38.
Zurück zum Zitat Fiske A, Wetherell JL, Gatz M (2009) Depression in older adults. Annu Rev Clin Psychol 5:363–389CrossRef Fiske A, Wetherell JL, Gatz M (2009) Depression in older adults. Annu Rev Clin Psychol 5:363–389CrossRef
39.
Zurück zum Zitat Oyserman D, Mowbary CT, Meares PA, Firminger KB (2000) Parenting among mothers with a serious mental illness. Am J Orthopsychiatry 70(3):296–314CrossRef Oyserman D, Mowbary CT, Meares PA, Firminger KB (2000) Parenting among mothers with a serious mental illness. Am J Orthopsychiatry 70(3):296–314CrossRef
40.
Zurück zum Zitat Diaz-Caneja A, Johnson S (2004) The views and experiences of severely mentally ill mothers. Soc Psychiatry Psychiat Epidemiol 9(6):472–482 Diaz-Caneja A, Johnson S (2004) The views and experiences of severely mentally ill mothers. Soc Psychiatry Psychiat Epidemiol 9(6):472–482
Metadaten
Titel
Identifying profiles of need among psychiatric inpatients approaching discharge in New York City: a latent class analysis
verfasst von
Kate L. McDonald
Jennifer M. Hoenig
Christina C. Norman
Publikationsdatum
02.01.2020
Verlag
Springer Berlin Heidelberg
Erschienen in
Social Psychiatry and Psychiatric Epidemiology / Ausgabe 1/2021
Print ISSN: 0933-7954
Elektronische ISSN: 1433-9285
DOI
https://doi.org/10.1007/s00127-019-01817-4

Weitere Artikel der Ausgabe 1/2021

Social Psychiatry and Psychiatric Epidemiology 1/2021 Zur Ausgabe

Demenzkranke durch Antipsychotika vielfach gefährdet

23.04.2024 Demenz Nachrichten

Wenn Demenzkranke aufgrund von Symptomen wie Agitation oder Aggressivität mit Antipsychotika behandelt werden, sind damit offenbar noch mehr Risiken verbunden als bislang angenommen.

Weniger postpartale Depressionen nach Esketamin-Einmalgabe

Bislang gibt es kein Medikament zur Prävention von Wochenbettdepressionen. Das Injektionsanästhetikum Esketamin könnte womöglich diese Lücke füllen.

„Psychotherapie ist auch bei sehr alten Menschen hochwirksam!“

22.04.2024 DGIM 2024 Kongressbericht

Die Kombination aus Medikamenten und Psychotherapie gilt als effektivster Ansatz bei Depressionen. Das ist bei betagten Menschen nicht anders, trotz Besonderheiten.

Auf diese Krankheiten bei Geflüchteten sollten Sie vorbereitet sein

22.04.2024 DGIM 2024 Nachrichten

Um Menschen nach der Flucht aus einem Krisengebiet bestmöglich medizinisch betreuen zu können, ist es gut zu wissen, welche Erkrankungen im jeweiligen Herkunftsland häufig sind. Dabei hilft eine Internetseite der CDC (Centers for Disease Control and Prevention).

Update Psychiatrie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.