Abstract
This study examined the impact of community characteristics on rehospitalization of chronically mentally ill (CMI) clients from public psychiatric hospitals in Virginia. The relationship between rehospitalization, often termed recidivism, and community attributes was explained within the theoretical context of community ecology (Hawley 1950). A small area analysis approach that employed path analysis was used to assess the relationship between rehospitalization and selected community variables including: available health care resources, socioeconomic factors, race, presence of psychopathology, and household composition. The path model was estimated and validated using a linear structural relations computer program (LISREL VI). Results reveal female-headed households and socioeconomic status to be significant predictors of rehospitalization. A discussion of implications of the findings for community mental health services delivery and research is provided.
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References
Bachrach, L.L. (1984). Asylum and chronically ill patients.American Journal of Psychiatry, 141, 975–978.
Bachrach, L.L. (1982). Assessment of outcomes in community support programs: results, problems and limitations.Schizophrenia Bulletin, 8(1), 39–60.
Belcher, J.R., (1988). Are jails replacing the mental health system for the homeless mentally ill?Community Mental Health Journal 24(3), 185–195.
Belcher, J.R. & First, R. (1987–88). The homeless mentally ill: Barriers to effective service delivery.Journal of Applied Social Sciences, 12, 62–78.
Blazer, D., George, L.K., Landerman, R., Pennybacker, M., Melville, M.L., Woodbury, M., Manton, K.G., Jordan, K., & Locke, B. (1985). Psychiatric disorders: A rural/urban comparison.Archives of General Psychiatry, 41, 651–656.
Cagle, L.T., & Banks, S.M. (1986). The validity of assessing mental health needs with social indicators.Evaluation and Program Planning, 9(2), 127–142.
Dowell, D.A. & Ciarlo, J.A. (1983). Overview of the community mental health centers program from an evaluation perspective.Community Mental Health Journal, 19(2), 95–125.
Faris, R.E.L. & Dunham, H.W. (1960).Mental disorders in urban areas. New York: Hafner Publishing Company.
Goldman, H.H., Gattozzi, A.A., & Taube, C.A. (1981). Defining and counting the chronically mentally ill.Hospital and Community Psychiatry, 32(1), 21–27.
Grusky, O., Tierney, K., Manderscheid, R., & Grusky, D.B. (1985). Social bonding and community adjustment of chronically mentally ill adults.Journal of Health and Social Behavior, 26(1), 49–63.
Hawley, A.H. (1950).Human ecology: A theory of community structure. New York: The Ronald Press Company.
Joreskog, K., & Sorbom, D. (1983).LISREL: An analysis of linear structural relationships by the method of maximum likelihood. (User's Guide, Version V and VI), Chicago: National Education Resources.
Leighton, A.H. (1967). Is social environment a cause of psychiatric disorder? In R.R. Monroe, G.D. Klee, & E.B. Brody (Eds.),Psychiatric epidemiology and mental health planning. Washington, DC: American Psychiatric Association.
Leighton, A.H. (1974). Social disintegration and mental disorder. In S. Arieti, (Ed.),American handbook of psychiatry. (2nd ed.) (Vol. 2). New York: Basic Books.
Levy, L., & Rowitz, L. (1973).The ecology of mental disorder, New York: Behavioral Publications.
Mechanic, D. (1986). Mental health and social policy: Initiatives for the 1980s.Health Affairs, 5, 75–88.
Neugebauer, R., Dohrenwend, B.P., & Dohrenwend, B.S. (1980). Formulation of hypotheses about the true prevalence of functional psychiatric disorders among adults in the United States. In B.P. Dohrenwend, et al.,Mental illness in the United States (pp. 45–94), New York: Praeger.
Noble, J.J. & Conley, R.W. (1981). Fact and conjecture in the policy of deinstitutionalization.Health Policy Quarterly, 1, 99–174.
Pindyck, R.S. & Rubinfeld, D.L. (1981).Econometric models and economic forecasts. (2nd ed.). New York: McGraw-Hill.
Redick, R.W. & Goldsmith, H.F. (1974).1970 census data used to indicate areas with different potentials for mental health and related problems. NIMH Mental Health Statistics, Series C, no 3, DHEW Publication No. (ADM) 75-159. Washington, DC: U.S. Government Printing Office.
Robins, L.N., Helzer, J.E., Weissman, M.M., Orvaschel, H., Gruenberg, E., Burke, J.D., & Regier, D.A. (1984). Lifetime prevalence of specific psychiatric disorders in three sites.Archives of General Psychiatry, 41, 949–958.
Rosen, B.M. (1977).A model for estimating mental health needs using 1970 census socioeconomic data. NIMH, DHEW Publication No. (ADM) 63-77. Washington, DC: U.S. Government Printing Office.
Rosen, B.M., Goldsmith, H.F., & Redick, R.W. (1979). Demographic and social indicators from the U.S. Census of population and housing: Uses in mental health planning in small areas.World Health Statistics Quarterly, 32(1), 11–101.
Schweitzer, L. & Kierszenbaum, H. (1978). Community characteristics that affect hospitalization and rehospitalization rates in a municipal psychiatric hospital.Community Mental Health Journal, 14(1), 63–73.
Tessler, R.C. & Manderscheid, R.W. (1982). Factors affecting adjustment to community living.Hospital and Community Psychiatry, 33(3), 203–207.
US Department of Health and Human Services. (1985).Public health service, health resources and services administration: Bureau of health professions area resource file. Springfield, VA: National Technical Information Service.
Virginia Department of Mental Health and Mental Retardation (VADMHMR). (1985).Virginia comprehensive state plan 1985–1990 volume II: System overview, issues and profiles, 16–24.
Wan, T.H. & Ozcan, Y. (1991). Determinants of psychiatric rehospitalization: A social area analysis.Community Mental Health Journal, 27(1), 3–16.
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Turner, J.T., Wan, T.T.H. Recidivism and mental illness: The role of communities. Community Ment Health J 29, 3–14 (1993). https://doi.org/10.1007/BF00760626
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DOI: https://doi.org/10.1007/BF00760626