Program structure and continuity of mental health care.

Continuity has been a much discussed but under-researched objective of mental health care, in part due to measurement challenges. A small body of research has identified program features associated with continuity, based on measures of service use. A recent planning project provided an opportunity to examine the effects of these features on continuity using a new self-report continuity measure. Nine program features were measured and linear regression analyses were used to assess the relationship between these features and continuity, controlling for client characteristics. Client continuity was higher in programs that offered some night or weekend coverage and lower in programs that provided more care in the community. This latter finding was unexpected and may represent program efforts to engage individuals experiencing difficulties with service access. The association between each of the other 7 program features and continuity was not significant. Possible explanations for this finding are explored.