A study of the effect of an integrated continuum of intensive crisis intervention services (ICICIS), including Assertive Community Treatment (ACT), on civil commitments in North Central West Virginia.

다국어 초록 (Multilingual Abstract)

The mental health service delivery system in West Virginia is ineffective at resolving psychiatric emergencies, as evidenced by a high civil commitment rate, leading to an annual $4 million non-budgeted expense to the state. West Virginia's two State hospitals are regularly at capacity, causing civil committed patients to be diverted to community psychiatric units, often at the state's expense. At one of the state's 13 Comprehensive Community Mental Health Centers (CCMHC), United Summit Center, two evidence based treatment modalities, ICICIS and ACT, are examined for their effectiveness at lowering the civil commitment rate per 100,000 and civil commitment hospitalization days. The results indicate that both modalities are effective. In evaluating the effectiveness of United Summit Center's ICICIS, a four-year study of commitment rates per 100,000 revealed a range for the 13 CCMHC of 38--462. The mean was 200. United Summit Center ranked second lowest with a rate of 65 per 100,000. In evaluating the effectiveness of United Summit Center's ACT program, 26 participants that had been in the program for one year, were compared across three conditions by an analysis of variance. The three conditions were annual civil commitment hospitalization days two years prior to joining ACT, one year prior to joining ACT and one year after joining ACT. The 26 participants averaged 60.35 civil commitment hospitalization days two years prior to joining ACT, 98.54 one year prior, and 18.73 one year after. The results showed significance at the p < 0.01 level when comparing civil commitment hospitalization days one year prior to joining ACT to one year after joining ACT.