The Association Between Client Characteristics and Recovery in California's Comprehensive Community Mental Health Programs.

MENTAL illness treatment; DIAGNOSIS of schizophrenia; DIAGNOSIS of bipolar disorder; CLASSIFICATION; COMPUTER simulation; CONVALESCENCE; CORRECTIONAL institutions; STATISTICAL correlation; DATABASES; HEALTH services accessibility; HEALTH status indicators; HOMELESSNESS; HOUSING; MEDICAL information storage & retrieval systems; INTEGRATED health care delivery; MINORITIES; PATIENT compliance; PATIENTS; PROBABILITY theory; RESEARCH funding; SUBSTANCE abuse; TIME series analysis; WHITE people; GOVERNMENT aid; INDEPENDENT living; TRANSITIONAL programs (Education); DESCRIPTIVE statistics

Objectives. In November 2004, California voters passed the Mental Health Services Act, which allocated more than $3 billion for comprehensive community mental health programs. We examined whether these county-level programs, known as "full service partnerships," promoted independent living arrangements (i.e., recovery) among their clients. Methods. We used Markov chain models to identify probabilities of residential transitions among 8 living arrangements (n = 9208 adults followed up to 4 years). We modeled these transitions on the basis of patterns of program participation and clinical and sociodemographic characteristics. Results. Interrupted program participation and substance abuse were significantly associated with a reduced likelihood of independent living and a greater probability of homelessness and incarceration. Persons with schizophrenia were the least likely to live independently, followed by persons with bipolar disorder. Compared with Whites, non-Whites were more frequently found to be homeless or in jail. Conclusions. Clients with sustained enrollment in California's comprehensive community mental health programs appear most likely to transition to independent living. The likelihood of this transition, however, shows a disparity in that ethnic minority clients appear least likely to transition to independent living. [ABSTRACT FROM AUTHOR]

Copyright of American Journal of Public Health is the property of American Public Health Association and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)