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How a Stressed Local Public System Copes with People in Psychiatric Crisis

Citation

Wells, Rebecca; La, Elizabeth Holdsworth; Morrissey, Joseph; Hall, Marissa G.; Lich, Kristen Hassmiller; & Blouin, Rachel (2013). How a Stressed Local Public System Copes with People in Psychiatric Crisis. Psychiatric Quarterly, 84(2), 255-70. PMCID: PMC3566366

Abstract

In order to bolster the public mental health safety net, we must first understand how these systems function on a day-to-day basis. This study explored how individual attributes and organizational interdependencies within one predominantly urban US county affected responses to individuals' needs during psychiatric crises. We interviewed clinicians and managers within the crisis response network about people at immediate risk of psychiatric hospitalization, what had happened to them during their crises, and factors affecting services provided (N = 94 individuals and 9 agencies). Social network diagrams depicted patterns of referrals between agencies. Iterative coding of interview transcripts was used to contextualize the social network findings. Often, agencies saw crises through to resolution. However, providers also limited the types of people they served, leaving many people in crisis in limbo. This study illustrates how attributes of individuals with mental illness, service providers and their interactions, and state and federal policies intersect to shape the trajectories of individuals during psychiatric crises. Understanding both the structures of current local systems and their contexts may support continued evolution toward a more humane and robust safety net for some of our society's most vulnerable members.

URL

http://dx.doi.org/10.1007/s11126-012-9245-z

Reference Type

Journal Article

Journal Title

Psychiatric Quarterly

Author(s)

Wells, Rebecca
La, Elizabeth Holdsworth
Morrissey, Joseph
Hall, Marissa G.
Lich, Kristen Hassmiller
Blouin, Rachel

Year Published

2013

Volume Number

84

Issue Number

2

Pages

255-70

PMCID

PMC3566366

Reference ID

12842