A model for evaluating intensive outpatient behavioral health care programs.

Abstract

This study proposes a model with five criteria for evaluating the effectiveness of intensive outpatient behavioral health care programs and applies this model to a brief partial hospital-crisis stabilization program. The five criteria are client selection, program attendance, service utilization and focus of treatment, client improvement, and cost-effectiveness. The program evaluation model was tested with a sample of 285 adults with severe mental illness who were admitted for or were receiving outpatient treatment at a state-funded community mental health center. Evaluation data included pre- and postprogram ratings by clinical staff of clients' symptoms, level of functioning, and treatment readiness; current and retrospective reports of clients' symptoms based on interviews with clients; and clients' service and financial records. Clients and clinicians also provided data about the problems addressed during treatment sessions. Program dropouts used significant facility resources before dropping out. Clients who participated in the partial hospital-crisis stabilization program showed reduced symptoms, improved daily functioning, and improved treatment readiness. Clients who showed more improvement cost less to treat. The evaluation model produced the information necessary for demonstrating program effectiveness. The results support the belief that clinical effectiveness and cost-effectiveness are positively related.