Cost and Cost-effectiveness of Hospital vs Residential Crisis Care for Patients Who Have Serious Mental Illness

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Abstract
MOST PATIENTS with severe mental illness are treated in community settings, where programs charged with caring for them operate under tight fiscal constraints.1,2 Economic studies of these programs point to acute care episodes involving hospitalization as the single largest cost element in the array of services needed to provide community care.3-5 In psychiatry, as in the rest of medicine, limiting use of costly inpatient services has been a major strategy for controlling costs.6,7 Concurrently, limitations in services, including acute care services with very limited lengths of stay, are widely perceived as placing serious burdens on the patients, community mental health systems, and the society that must absorb and manage the consequences of inadequately treated mental illness.8-10