Table 1 Comparison of care transition factors across children’s, adult, and VA Mental Health (MH) service contexts

Environmental/Influence

  External Environment

    1. Geographical Characteristics

1. Characteristics location of where services are provided (e.g., urban vs. rural area, average socioeconomic status of residents)

X

X

X

    2. Community Capacity and Availability

2. Local community availability and offering and/or capacity to provide services, including alignment with insurance model

X

X

X

    3. Service Provision Policy

3. Broader policies and legislation related to eligibility and service provision

X

X

X

    4. Prioritization of Suicide Prevention

4. Local or broader prioritization of suicide prevention, both formally (e.g., policies, legislation) or informally (purveyor organizations, advocacy organizations)

X

X

    5. Demand for MH Care

5. Current events driven changes in demand for mental health care (e.g. military conflicts)

X

  Systems of Care

  1. Integration of Multiple Services Within and Across Sectors

1. The extent to which there is integration within and across multiple sectors of care (e.g., mental health and addiction, family and social services, corrections, education) serving the same patient population, in terms of policies, infrastructure, and processes.

X

X

X

  2. Focus on Recovery

2. Prioritization or implementation of recovery-oriented care in addition to crisis services

X

  3. Availability of Diverse Treatment Modalities

3. Availability and/or capacity to provide diverse services within the health care system

X

X

  4. Within System Accessibility of Services

4. Accessibility of services between agencies or providers within a care system

X

X

X

  5. Organizational Practice Culture

5. Organizational service provision or practice models or culture

X

X

Population Characteristics

  Provider Characteristics

    1. Training and Knowledge

1. Prior experience with formal or informal training and/or knowledge regarding mental health and mental health care transitions

X

X

    2. Experience

2. Prior service provision experience including experience with various service types, agencies, an/or other providers and clients

X

    3. Attitude and Beliefs

3. Attitudes and beliefs related to mental health and mental health service provision

X

    4. Interprofessional Collaboration

4. Experience and/or preference specific to collaboration with other professionals and/or disciplines

X

X

Client/Patient Characteristics

  1. Functioning Level and Symptoms

1. Level of functioning, presenting symptoms, presence of co-occurring conditions, clinical complexity, and/or service needs

X

X

X

  2. Race/Ethnicity

2. Race and/or ethnicity status

X

X

  3. Resources and/or Social Support

3. Available resources and/or supports (e.g., SES, social support networks)

X

X

  4. Age

4. Age as it relates to receipt or access to services, including age-related transitions between systems of care

X

X

X

  5. Gender

5. Gender as it relates to receipt or access to services

X

  6. Homelessness

7. Housing status or access to housing

X

X

  7. Involvement in multiple systems of care

8. Receiving care from, and which from more than one system of care

X

X

X

  8. Insurance Status

9. Current insurance type, benefits, and/or status

X

X

  9. Attitudes and Beliefs

10. Attitudes and beliefs related to mental health and mental health services

X

Caregiver Characteristics

  1. Caregiver Perceptions & Experience

1. Prior service provision experience with services, including various service types, agencies, providers

X

  2. Caregiver Psychosocial Factors

2. Factors related to functioning, symptoms and/or characteristics

X

Health Behavior

  Client/Patient Health Practices

    1. Engagement in Care

1. History of and/or current engagement in services, including care attendance and participation

X

X

X

    2. Medication Adherence/Compliance

2. Adherence or compliance to care recommendations and plans

X

X

    3. Report of Symptoms

3. Tendency to under or over report current symptoms or functioning

X

    4. Substance Use

4. Use of substances

X

X

X

    5. Expectations or Readiness for Care

5. Expectation and/or readiness for care

X

X

X

Use of Health Services

  1. High Relapse Rates

1. Rates of relapse and impact on service needs and usage

X

X

  2. Focused Care for Posttraumatic Stress Disorder

2. Availability/utilization of care specifically targeting trauma related symptoms

X