PMID: 8590109Dec 1, 1995Paper

A review of studies of heavy users of psychiatric services

Psychiatric Services : a Journal of the American Psychiatric Association
S KentP Yellowlees

Abstract

This paper reviews studies of patients who are heavy users of psychiatric services and identifies areas in which further research and evaluation are indicated. Extensive searches were conducted of the English language psychiatric and psychological literature before 1994. Important references from initially identified studies were followed up. More than 200 articles were reviewed, 72 of which are described in this review. The 72 papers were selected because they dealt with three questions: What is heavy service use? What patient characteristics contribute to it? What service delivery characteristics contribute to it? Criteria for identifying and defining heavy users of psychiatric services vary among studies. Few studies of heavy service users have attempted to examine use of all psychiatric services, both inpatient and community based. In most studies, 10 to 30 percent of patients are identified as heavy users, those who utilize between 50 and 80 percent of service resources. This group consists of a constantly changing cohort of patients who generally have psychotic illnesses as well as comorbid personality disorders and high levels of drug and alcohol misuse. Few studies have examined social issues such as isolation, homeless...Continue Reading

Citations

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