PubMed Health⌕ Search

Biomedical subjects

L L Bachrach

Publications and source records attributed to L L Bachrach.

At least 37 records · Page 2Linked to original sources
PubMed1993

Continuity of care and approaches to case management for long-term mentally ill patients.

Consensus does not yet exist about the definition of case management as it is practiced in the care of long-term mentally ill patients. Case management interventions may be arrayed on a continuum, with brokering and clinical approaches at the poles. However, most actual case management programs fall along the continuum and not at the extreme poles. The functions of case management in the care of long-term patients correspond closely to nine principles of continuity of care that transcend specific case management styles. The nine principles are an administrative climate supportive of long-term patients, ready access by patients to the services they need, provision of a full array of services, individually tailored treatments, flexible program offerings, linkage among agencies serving the patient, a continuing relationship between patient and caregiver, patient involvement in service planning, and recognition of cultural factors affecting treatment. The author discusses how the concept of continuity of care can be used in considering policy issues such as staffing of case management services and suggests that service systems may find it advantageous to offer several different case management approaches to accommodate patients' individual needs.

Chronic Disease↗
PubMed1993

Ensuring services for persons with chronic mental illness under national health care reform.

People with chronic mental illness present complex challenges for the design of health care financing reforms. In this position statement from the committee on psychiatry and community of the Group for the Advancement of Psychiatry, the authors describe chronic and severe mental illnesses as psychiatric illnesses that require acute and ongoing psychiatric assessment and treatment, as chronic medical diseases that require ongoing rehabilitative services, and as persistent disabilities that need ongoing supportive care and social services. Any proposal for health care reform must ensure parity of chronic psychiatric illnesses with other psychiatric conditions. It must also reimburse psychiatric rehabilitation at parity with other medical rehabilitation and provide equal access to and reimbursement for broad ancillary health services that reduce costs and improve quality of life.

Chronic Disease↗
PubMed1992

Psychosocial rehabilitation and psychiatry in the care of long-term patients.

The relationship between psychosocial rehabilitation and psychiatry in the care of long-term mental patients is one that may often be characterized, at best, as an uneasy alliance. The author summarizes the basic concepts that define the discipline of psychosocial rehabilitation and discusses how those concepts have at times been distorted in actual practice. The article concludes with an analysis of the two disciplines' common ground in caring for long-term patients and a commentary on the benefits that each may offer the other. Together psychiatry and psychosocial rehabilitation hold the key to improved circumstances for realizing the promise of deinstitutionalization, which seems largely to have eluded us for the past several decades.

Deinstitutionalization↗
PubMed1992

What we know about homelessness among mentally ill persons: an analytical review and commentary.

Although extensive research on the homeless mentally ill population has been conducted, existing studies have failed to answer three important questions: the prevalence of chronic mental illness among homeless persons, whether deinstitutionalization has precipitated increased homelessness in this population, and what kinds of services should be offered. The author suggests that future research will require clearer definition of the terms used in discussing this population and calls for increased federal direction in making policies to respond to their problems, especially the problems of those who are geographically mobile. Successful service planning must address the full array of disabilities experienced by homeless mentally ill persons, including psychiatric symptoms, secondary responses to the experience of illness, and disabilities resulting from stigma and lack of societal opportunity.

Chronic Disease↗
PubMed1991

Service planning for chronic mental patients: some principles.

Services for chronic mental patients in this era of deinstitutionalization present a major challenge to clinicians and planners alike. The complexity of these patients' clinical and other programmatic needs requires that an array of viable comprehensive services be made available to them. Following certain established principles of service planning will help facilitate patients' longitudinal, psychological, financial, and geographical access to care.

Delivery of Health Care↗
PubMed1990

Homeless mentally ill patients in the community: results of a general hospital emergency room study.

Previous inattention to the specific circumstances of homeless mentally ill individuals in general hospital settings is discussed. Homeless mentally ill individuals who presented for emergency psychiatric care in a public general hospital setting exhibited distinctive patterns of service utilization and showed evidence of being a uniquely disabled, rootless, and impoverished subgroup of mentally ill individuals. The characteristics of homeless users of general hospital psychiatric services may provide some important clues to system-wide deficits in community-based care for the members of this population.

Adult↗