Caring for Previously Hospitalized Consumers: Progress and Challenges in Mental Health System Reform (December 2008)

Building on the July 2008 Program Evaluation Division process evaluation, this report examines services delivered by the North Carolina Division of Mental Health, Developmental Disabilities and Substance Abuse Services after system reform. Analyses of services received by 22,516 individuals previously hospitalized in substance abuse or psychiatric facilities suggest that gaps in community-based services persist among those discharged from state-operated facilities, and among individuals with a history of one, versus multiple, hospital discharge. Individualized tracking across facilities, service types, and funding sources is needed to improve continuity of care and to generate comprehensive statewide data. System oversight and management should focus on increasing capacity and quality of community-based services.

Final Report

Executive Summary



Agency Actions:

  • Many local providers and Local Management Entities have initiated electronic records projects. However, due to legislative and budget constraints on state-supported IT projects, the division has discontinued its pursuit of a statewide electronic health record. The division changed practice and infrastructure to improve inpatient and outpatient services and increase access to crisis intervention and coordination of care following crisis and inpatient treatment; implemented two provider performance assessment tools to improve system oversight; and introduced quarterly reporting on provider monitoring.