Impact of an alternatives program on client utilization of services in a county mental health system

To evaluate the effectiveness of a county alternatives-to-hospitalization program in reducing patients' use of inpatient services, the author compared use of services by 357 clients before and after their admission to the alternatives program. Program admission was followed by overall reductions in clients' use of mental health services, particularly inpatient services, and in their rate of return to an inpatient setting. The type of program a client was involved in immediately before entering the alternatives program was predictive of the amount and type of subsequent treatment. Clients who transferred to the alternatives program from an inpatient setting subsequently used inpatient services the most. The author believes information about patterns of service use can be helpful in designing treatment strategies and programs.