Bridging the Acute-to-Outpatient Care Gap in Mental Health: Developing and Implementing a Mental Health Transition Process.

Background: A national Department of Veterans Affairs (VA) mental health (MH) quality metric tracks engagement in outpatient MH care after discharge from residential and inpatient settings, with recommendations for 2 or more visits 30 days postdischarge.

Local Problem: A gap in transitioning patients from residential to outpatient MH care was identified at this site.

Methods: A transition management process was developed and piloted, including a new MH Discharge Consult and an RN Transition Care Managers team.