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Wednesday, December 6 • 5:15pm - 5:30pm
Outcomes and Treatments for Those Involuntary Hospitalized - A Deep Dive of Allegheny County

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In this study we analyze the involuntary hospitalization program in Allegheny County using high quality administrative data. We find that individuals who are hospitalized have very poor outcomes upon release - within 5 years of their first hospitalization fully 20% of the population has died, a rate that is higher than that for the jail, shelter, and SNAP receiving populations as well as that for folks with severe mental illness (SMI). Mortality rates are elevated in the first two years (especially the first year), producing a ‚Äúcrisis window‚Äù where adverse outcomes are especially likely to occur. We see especially poor outcomes among individuals with a pre-existing substance use disorder - 6% of those with SUD 18-50 years of age die within two years of release, compared to 4% of the 18-50 year olds without SUD, largely of drug overdose. When we look at other outcomes besides mortality, we also find similar poor outcomes. Over 23% have been charged with a crime within 5 years of release, and 60% use an emergency room within one year of release. Not only are base rates high among the population, but statistical methods can distinguish between riskier and less risky portions of those hospitalized with high accuracy, meaning that there is potential for targeting of step down programs to high acuity populations.  Individuals who are involuntarily hospitalized are well known to the system before their first hospitalization. Fully 50% bill mental / behavioral health services in the month before their hospitalization, and 72% in the year prior. Seven in ten have pre-existing SMI diagnoses. After their hospitalization, they are frequent users of services. This cohort accounts for 23% of mental / behavioral Medicaid spending in Allegheny County, despite accounting for just 8% of folks who bill through Medicaid and 1.5% of all Medicaid enrollees. We analyze petition upheld rates among different demographic groups and see no significant differences, though those petitioned to get a 302 are much more African American and much less Caucasian than the county as a whole. Involuntary hospitalizations are common, with a rate of 305 per 100k in Allegheny County. This is somewhat shy of an estimated 357 per 100k nationally. Taken together, this study paints a rich tapestry of information regarding outcomes and service utilization among those involved in involuntary hospitalization, and suggests changes to the system to ultimately improve outcomes.

Learning Objectives:
  • Understand more detail about how involuntary hospitalizations work and are administered.
  • Gain a deeper understanding of what happens after an involuntary hospitalization.
  • Learn approaches for improving outcomes among those leaving an IH session.

avatar for Pim Welle, PhD

Pim Welle, PhD

Professional Data Scientist, Allegheny CountyDepartment of Human Services
Pim Welle is a professional data scientist who works at the intersection of quantitative social sciences and mental health. He is an adjunct professor of data science at Carnegie Mellon University as well as a data science fellow at Allegheny County Department of Human Services.

Wednesday December 6, 2023 5:15pm - 5:30pm PST
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