Thesis Title: A Needs Assessment and Program Intervention for Patients in Mental Health Crisis in Lieu of Admission to the Emergency Department of Rapides Regional Medical Center, Rapides Parish, Louisiana Open Access

Robinson, Daphne Renee (2016)

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Community-based services for patients in mental health crisis in Rapides Parish, Louisiana, are virtually non-existent. Consequently, persons who suffer from chronic mental illness frequently seek non-emergency services in the Emergency Department (ED) of Rapides Regional Medical Center (RRMC), the largest hospital in central Louisiana. This study is a community needs assessment that focuses for the first time on the needs of the patient population in mental health crisis in central Louisiana and evaluates community-based services that could be successfully implemented to serve those needs.

Table of Contents

TABLE OF CONTENTS Chapter 1: Overview 1 A. Problem Statement 1 B.Purpose 2 C. Significance of the project 3 D. Mental Health in Louisiana 4 F. Mental Health in Rapides Parish 8 Chapter 2: Literature Review 17 Chapter 3: Data Collection, Analysis and Results 30 A. Theoretical Framework 30 B. Data Collection and Results 34 Chapter 4: Discussion 37 A. Quantitative Data 37 B. Qualitative Data 43 C. Limitations 48 D. Recommendations 49 E. Questions That Remain After Data Collection 68 Chapter 5: Front Page of Journal Article (Appendix 2) 71 REFERENCES 71 List of Figures Figure 1: Map of Rapides Parish, Louisiana (PRC, 2013) 9 Figure 2: Map of Designated Medically Underserved Populations in Louisiana (PRC, 2013) 11 Figure 3: Primary Care HPSA Map of Louisiana (PRC, 2013) 14 Figure 4: Optimal Mix of Mental Health Community Services (WHO, 2015) 25 Figure 5: Schematic overview of risks to mental health over the life course (Adapted from: Foresight Project, 2008; Kieling et al, 2011; Fisher et al, 2011) (WHO, 2012) 32 Figure 6: Diagram of the Socio-Ecological Model(CDC, 2015) 33 List of Tables Table 1: Target Population Breakdown by Gender 38 Table 2: Target Population by City 39 Table 3: Target Population History of Mental Illness 40 Table 4: Target Population History of Mental Illness by Gender 41 Table 5: Target Population and In-Patient Facility 43 List of Appendices Appendix 1: Key Stakeholder Interview Questions 77 Appendix 2: First Page of Journal Article 78

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