How are we doing? A statewide survey of community adjustment among people with serious mental illness receiving intensive outpatient services.

Although mental health consumers often prefer community living, the factors influencing community outcomes are not well understood. In order to address this issue in Connecticut, the Department of Mental Health and Addiction Services (DMHAS) commissioned a statewide study of 6,800 clients receiving the most intensive community-based mental health services funded by the state. DMHAS clinicians provided the ratings for their clients on a variety of variables including demographics, diagnosis, clinical stability, current psychotic symptomology, adherence to prescribed medications, substance abuse, history of violent crime, community trouble-making or victimization, likelihood of threatening behavior, frequency of social contacts, and difficulty in adjusting to life in the community. Also, the total length of stay and total number of admissions during a two year period were taken from the statewide management information system for each client in the study. Descriptive data analysis included frequencies and means to describe the demographic, the diagnostic, and the clinical profile of the DMHAS clients. A stepwise hierarchical multiple regression analysis (MRA) was performed to determine what factors predict a composite score of overall functioning, community adjustment, and psychiatric impairment. Clients with better composite scores were those who had a prescription for medications, adhered more to their medication regimen, perceived to be less threatening, and had more frequent social interactions. Implications of these findings for outpatient treatment are discussed.