PhD

dissertationPeople with severe and persistent mental illnesses often require a representative payee, a third party responsible for utilizing public support to insure that day-to-day basic economic demands of living within the community are met. This study examined the changes in utilization of mental health services 12 months prior and 12 months following implementation of the benefit representative specialist (BRS) initiation. This study also examined the change in cost of care for services 12 months prior and 12 months following implementation of BRS initiation. Community mental health (CMH) agency databases were analyzed for services. Services were grouped into three categories: (a) number of days of inpatient psychiatric hospitalization, (b) outpatient CMH agency services, and (c) CMH agency supported housing. Subjects utilizing CMH agency-supported housing utilized BRS services twice as often as those subjects not in CMH housing. Subjects not in housing increased their utilization of day treatment. CMH housing represented the highest cost program. BRS initiation was the lowest cost program. Changes in service utilization indicated increased treatment compliance/participation by subjects. Number of days of impatient psychiatric hospitalization was found to be unexpectedly low