HSR&D Citation Abstract
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Matarazzo BB, Forster JE, Hostetter TA, Billera M, Adler G, Ganzini LK, Oslin DW, Brenner LA. Efficacy of the Home-Based Mental Health Evaluation (HOME) Program for Engaging Patients in Care After Hospitalization. Psychiatric services (Washington, D.C.). 2019 Dec 1; 70(12):1094-1100.
The risk of suicide is elevated in the days and weeks after discharge from a psychiatric hospitalization, and lack of treatment engagement posthospitalization is also associated with suicide. The authors sought to determine whether the Home-Based Mental Health Evaluation [HOME] Program is efficacious in helping patients engage in care after psychiatric hospitalization.
This study was a nonrandomized, controlled, two-arm (HOME Program versus enhanced care as usual [E-CARE]) trial that took place at four Department of Veterans Affairs medical centers. Participants (N = 302) were patients admitted to a psychiatric inpatient unit. The HOME Program consists of phone- and home-based contacts that include suicide risk assessment, safety planning, and problem-solving around barriers to care. The primary outcome was treatment engagement, as documented in the electronic medical record.
Veterans in the HOME Program group were 1.33 (95% confidence interval [CI] = 1.29-1.37) times more likely to engage in treatment, compared with veterans in the E-CARE group (p < 0.001). HOME Program participants were estimated to have attended 55% more individual appointments (95% CI = 12%-113%, p = 0.02), compared with those in the E-CARE group. The adjusted difference in median time to treatment engagement was 15 days (95% CI = 3.5-27.0) such that HOME Program participants engaged in treatment more quickly than participants at the E-CARE sites.
Findings suggest that participation in the HOME Program can help individuals at high risk of suicide engage in care after psychiatric hospitalization.