An Evaluation of a Community-Based, Integrated Crisis-Case Management Service

Abstract

This study presents findings of an evaluation of a community-based crisis service that used systems enhancement funding to modify services. In addition to developing timelier crisis services and increasing mobile capacity, the service adaptations focused on broadening the scope of the crisis service and addressing the follow-up needs of individuals served. While service development was guided by the research and best practice literature, there was little guidance available on how to address the latter two goals. The development of a transitional case management model integrated with crisis services was an innovation in service delivery. The evaluation used existing databases to compare crisis service delivery between two distinct periods (i.e., “old model” vs. “new model”). Study findings suggest that the new model did lead to the expected changes in service utilization patterns, specifically to increased service capacity, greater access to mobile crisis services, improved access to a broader community population, and more appropriate patterns of service delivery with respect to fewer days of crisis service and exit dispositions more consistent with crisis resolution. Rankings of acceptance of the new crisis service by the local service network varied greatly across service sectors, suggesting the need for more strategic community outreach efforts. The findings indicate that policy and funding opportunities within the mental health system need to be flexible and sensitive enough to address emerging issues in the field and to facilitate service innovations.