On average over the last eight, more than 98% of CSP clients have engaged in services at Washington County Mental Health within 30 days of being discharged from a psychiatric hospitalization. The majority of clients we serve through CSP (more than 80%) participate in our services voluntarily, and can chose to have contact or disengage after discharge from a psychiatric unit, but most choose to engage with services. Very few clients enrolled in CSP refuse contact after a hospitalization, or wait more than 30 days to make contact. In fact, last year, 100% of CSP clients had contact with a service provider within 30 days of discharging from a psychiatric hospitalization.
While most clients are wanting contact with staff throughout their hospital stay, and following their discharge, some choose to go though this experience without support from WCMHS providers. Those clients may leave psychiatric hospitalizations against medical advice; discharge to nursing homes or assisted living facilities out of county; transfer to medical units where they pass away, or seek services elsewhere (possibly because involuntary hospitalization damaged the therapeutic alliance). As the numbers reflect, most individuals who receive services in the Community Support Program, are wanting to have continued contact with staff at WCMHS.
Whenever possible, case managers are working with clients and hospital staff throughout the hospital stay to plan for a successful discharge back to the community. In some cases this means a case manager will be having ongoing meetings with a client and hospital staff, and on the day of discharge will pick up the client to bring them home, stopping at the pharmacy to fill prescriptions and at the grocery to get food, before settling them into their home, and scheduling a follow-up appointment. In other cases clients may prefer to go through the discharge process with friends or family, or on their own. After being surrounded by health professionals and patients around the clock at the hospital, some clients prefer to discharge home and take some space to themselves before jumping right back into treatment. In these cases, the time they take to connect with providers is usually only a few days. Over the past seven years, contact with clients has happened within 24 hours of discharge from a psychiatric hospitalization, 74% of the time; and within one week of discharge 95% of the time. Whenever possible staff are maintaining a connection with clients throughout the hospitalization, discharge, and period following hospitalization. Ultimately, clients decide when their first contact will be with staff, post discharge. What works best is to offer support and assistance and then to respect the clients personal choice and boundaries.