A randomized trial: are care navigators effective in connecting patients to primary care after psychiatric crisis?

Community Ment Health J. 2010 Aug;46(4):398-402. doi: 10.1007/s10597-010-9300-x. Epub 2010 Mar 5.


Persons with serious mental illnesses suffer excess medical morbidity compared to the general population. This RCT aimed to determine whether navigators are effective in helping patients connect to primary care after psychiatric crisis. Adults presenting for emergency care were randomly assigned to a navigator versus usual care. Navigators facilitated access to primary care. Outcomes were connection rates to medical care and the impact of health insurance, hospitalization and mental health care on primary care attendance. After 1 year, the intervention group was statistically more likely to access care, versus controls (62.4 vs. 37.6%, P < .001). Navigators were effective in helping patients connect to primary care after a psychiatric crisis. Improved access to primary care is important given the complex chronic health problems of this vulnerable cohort.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Community Mental Health Services
  • Comorbidity
  • Cooperative Behavior*
  • Crisis Intervention*
  • Diagnosis, Dual (Psychiatry)
  • Emergency Service, Hospital
  • Female
  • Follow-Up Studies
  • Health Services Accessibility
  • Health Status
  • Humans
  • Insurance Coverage
  • Interdisciplinary Communication*
  • Male
  • Mental Disorders / diagnosis
  • Mental Disorders / psychology
  • Mental Disorders / rehabilitation*
  • Middle Aged
  • Primary Health Care*
  • Psychotic Disorders / diagnosis
  • Psychotic Disorders / psychology
  • Psychotic Disorders / rehabilitation*
  • Referral and Consultation*
  • Substance-Related Disorders / diagnosis
  • Substance-Related Disorders / psychology
  • Substance-Related Disorders / rehabilitation*
  • Uncompensated Care
  • Urban Population*
  • Young Adult