Disposition Options for Discharged Patients

1. Call the attending overnight to discuss patients who are being discharged

2. Contact existing treaters to arrange prompt follow-up.

If no treaters exist, you need to make a referral for follow-up. The APS can be used as a ‘check-in’ for safety and medications for the short-term. Options for long term care include:

MGH Adult Outpatient Clinic (724-PSYC)

Can be a long waiting list, so best used for patients with an existing MGH PCP, if one time consultation is needed of if you are referring the patient to yourself or another resident. If you are anticipating the patient will need follow-up within two weeks, i.e. before an outpatient visit can be arranged, this should be done in the APS. Triage can also help find offsite care for patients as well as screen patients for clinical trials, but do not promise follow-up care at the main campus.

If you do refer to Triage, send a copy of the APS note to “Psychiatry Triage, ACC-812”. If patient needs an MGH PCP, have him call 6-5800.

MGH Psychiatry Residents may see outpatients covered by indemnity plans, Medicare, MassHealth, Neighborhood Health Plan, Tufts, Parterners Plus or free care, but NOT by HMO Blue, Blue Care Elect, Blue Care 65, Health Care Value Management, United Health Care, United Behavioral Health, Secure Horizons, Harvard Pilgrim or Travelers.

Community mental health centers and resources

MGH Affiliated Clinics

North Suffolk Mental Health

State Agencies

*General hospital, with geriatric, immune deficiency, head trauma, locked TB, med-surg-behav units, detox facility, prison medical facility operated by Dept of Corr, residential AIDS facility (Living in Recovery), and Bay Cove MHC, a 5-floor DMH facility.

Referrals and Hotlines

*The 411 operator will give the number of nearest shelter for battered women.

Self-Help Groups

Social Service Referrals

Walk-in intake: M-F, 9A-12N, 1P-5P. Patients with MGH PCP should be referred to PCP social worker. Otherwise page EW social worker.

HAVEN provides multiple services relating to domestic violence, including evaluation, intervention and follow-up with ED patients: contact 4-0054, or page ED social worker/ nurse specialist

Shelters

Homeless Referrals

Enrollment or primary care follow up: Medical Walk-In; 6-2707

Consultation: page Dr Michael Bierer or covering MD (6-1818)

Boston Health Care for Homeless network (534-5090, pg 221-6565)

Homeless Outreach (2^nd floor of ELMHC): 727-5500 ext 137