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Veterans Engaged in Treatment, Skills, and Transitions for Enhancing Psychiatric Safety (VETSTEPS).

Alisha M Wray,Tim Hoyt, Stephen Welch, Sara Civetti, Nicholas Anthony, Edward Ballester,Rajiv Tandon

PSYCHIATRIC REHABILITATION JOURNAL(2019)

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摘要
Objective: The transition after inpatient psychiatric care is a critical time with increased risk. This brief report evaluates Veterans Engaged in Treatment, Skills, and Transitions for Enhancing Psychiatric Safety (VETSTEPS), a program designed for this critical time. Method: Three "bridging" strategies were employed: (a) using inpatient-outpatient care collaboration; (b) four phone calls within seven days of discharge; and (c) a 4-week, evidence-based intervention that provided safety planning, coping skills, and triage services for postdischarge needs. Using retrospective data from 219 military veterans, VETSTEPS impact on treatment follow-up rates and veteran readmissions was examined. Results: Group participation was associated with significantly sooner mental health follow-up access, for both first and second follow-up appointments. Greater group participation was associated with lower rates of 12-month readmission, with more attended sessions associated with fewer readmissions when controlling for length of stay and previous readmissions. Following a hospital-wide strategy to implement VETSTEPS team phone calls, exploratory analyses indicate the facility's mental health care follow-up rate significantly improved from 55% to 79%, with sustained gains above 80% for two years. Conclusions and Implications for Practice: Program evaluation data suggest that bridging critical time interventions may improve outcomes for veterans recently discharged from psychiatric hospitalization.
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关键词
inpatient hospitalization,psychiatric,suicide,treatment engagement,veteran,military
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