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December 5 , 2005
Grant
funds mental-health service study for homeless
By Alicia Sands Lurry
Raymond Kotwicki, assistant professor of psychiatry
and behavioral sciences in the School of Medicine, has received a
$250,000 from the United Way to reach out to metro Atlanta’s
homeless population. The grant will fund Kotwicki’s Education
and Community Services Engagement Linkage (ECSEL) research study,
which began last month.
The study will compare two similar groups of patients,
one experimental and one control. Half the participants will receive
the same care
they are currently
getting through Grady Hospital, but individuals in the experimental group will
receive enhanced levels of case management and services.
“The overall goal of this project is to combine intensive case management,
education and coordination of services for individuals with serious mental illnesses
who frequently use costly safety-net services. We hope to demonstrate that enhanced,
coordinated care will prevent them from going back to the streets,” said
Kotwicki, principal investigator of the study and medical director of the Community
Outreach Services Program at Grady. “This grant is an effort to provide
competent, timely and appropriate mental health services to people who face multiple
significant legal, housing and treatment challenges in the Atlanta area.”
ECSEL is based on a 2000 demonstration project in Harris
County, Texas, in which there was some success, but several outcome
data—including economic and
some clinical variables—were not measured.
Patients participating in the study will be identified
through the court system, the psychiatric emergency care system or
jails. A
total of 30 individuals will
be randomized into the control group and will receive normal care through Grady’s
Behavioral Health Services. They will have access to a primary social worker
to coordinate mental health services, as well as case management and nursing
services.
Another 30 individuals will be randomly assigned to
the ECSEL program team. They will receive intensive clinical team
intervention from
case managers,
social
workers and a psychiatrist, as well as placement in permanent housing, financial
management and assistance, resource assistance and support, vocational training
and education, supportive counseling, psychiatric evaluation, and medication
administration and monitoring.
“The individuals receiving care through ECSEL are some of the leading users
of expensive tertiary care such as psychiatric emergency services, hospitals
and jails,” Kotwicki said. “We hypothesize that the life-support
and case-management services provided to homeless individuals will cost taxpayers
less than safety net health services and jail.”
Kotwicki plans to publish the data from ECSEL once
the project is completed and hopes mental health advocates will find
his study
helpful in their continuing
efforts to improve mental health services in Georgia and the United States.
Pending continued funding, participating individuals
will continue receiving services following the study’s conclusion,
either less acute services (if they show improvement) or services
similar to those provided through ECSEL.
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