Remote Outreach Follow-Up After Acute Mental Healthcare Utilization: Feasibility and Challenges

BACKGROUND AND OBJECTIVES: Postdischarge from acute mental healthcare settings (psychiatric emergency room and inpatient psychiatric unit) is a high-risk period in which prompt connection to outpatient mental healthcare is critical. While remote outreach interventions to enhance continuity of psychiatric care for patients during the transition from acute care to outpatient settings have demonstrated effectiveness, interventions designed specifically for the higher-risk population who are challenged with initially connecting with outpatient care are lacking. The authors aimed to explore the feasibility of a pilot hospital quality improvement intervention for this population that directly combines outreach with an ad hoc remote psychiatric appointment. METHODS: The intervention, wherein a psychiatrist repeatedly called the patient to complete a remote psychiatric appointment, was delivered to 50 adults discharged from acute mental healthcare settings who missed their scheduled postdischarge clinic appointment. This group was compared with a historical control group under a 2-group nonequivalent groups design. RESULTS: Of those called, 50% completed follow-up appointments and 72% of these were completed upon the first week of call attempts. Fewer in the intervention group had an acute mental healthcare utilization within 90 days from discharge (26% vs 42%), although this was not statistically significant. CONCLUSIONS: Remote outreach and delivery of an ad hoc psychiatric appointment is feasible. However, extended follow-up attempts may offer limited benefit and other engagement strategies may be needed. Future innovative postdischarge interventions should be specially designed to maximize impact for higher-risk patients.