Among women with severe mental illness diagnoses, early or long term exposure to physical or sexual abuse is associated with complex and severe psychiatric problems. These include psychotic symptoms, dissociation, and multiple self harming behaviors like para suicide, self mutilation and substance use. Without a unifying framework for services, women with these clinical profiles face problems in successfully negotiating treatment systems or establishing lives that include stable relationships, housing or employment. It is also likely that trauma exposure adds substantially to ineffective utilization of intense and long term services, especially when the service system does not explicitly address trauma.
Results of a study will be presented that tests the hypothesis that people with co occurring trauma histories and severe mental disorder present a greater public cost burden than people with severe mental illness alone—at least in a service environment that has not dedicated resources that address trauma. Service utilization and costs of persons with and without trauma histories will be compared using a data set that includes Medicaid claims and state hospital use from 1995 through 1997, and trauma histories for 1,251 Medicaid recipients who used the state hospital between 1988 and 1995. Public burden will be a function of general health and mental health service use as well as stays in the state hospital and in supported housing programs.
Learning Objectives: At the conclusion of the session attendees will be able to identify clinical and utilization profiles associated with co occurring severe mental illness and trauma exposure; describe the methodology of an economic cost study and articulate the fiscal importance of providing adequate services for this population
Keywords: Mental Health Services, Cost Issues
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.