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Objective: Individuals with co-occurring psychiatric and substance abuse problems often exhibit poor outpatient treatment engagement and re-hospitalization following discharge from acute psychiatric services. Although case management can improve treatment engagement and reduce attrition, these services are often delivered indefinitely, limiting the availability of treatment slots. In an effort to reduce re-hospitalization rates and improve outcomes during the transition from inpatient to outpatient treatment, we developed and evaluated Time-Limited Case Management (TLC), an eight-week integrated mental health and substance abuse augmentation intervention. Method: Sixty-five dually diagnosed veterans admitted to inpatient psychiatric treatment were included in the program evaluation, 32 who received the TLC service in addition to Treatment as Usual (TAU) that began during inpatient treatment and continued after the transition to outpatient services, and a comparison group of 33 who received only TAU without transitional support provided through the TLC augmentation service. Results: The TLC group had fewer days and episodes of hospitalization at two and six month post-study entry. Furthermore, the TLC group exhibited greater improvements on the Global Assessment of Functioning from baseline to the six-month follow-up. Conclusion: TLC appears to be an effective transitional augmentation service with benefits that persist beyond the eight weeks of the program. Future research should include a larger and more rigorously controlled trial to confirm the efficacy and unique contributions of the intervention.

Existe la necesidad de reforzar la capacidad regional para la vigilancia de las enfermedades crónicas en las Américas. Los objetivos de este artículo son 1) ofrecer nuestro apoyo decidido a favor de la vigilancia de las enfermedades crónicas, 2) presentar una revisión descriptiva y un resumen de las actividades de vigilancia y los problemas en torno a las mismas en las Américas, 3) confeccionar una lista de recursos y fuentes de consulta para obtener más información, y 4) ofrecer unas recomendaciones para reforzar la capacidad regional. Este artículo se basa en una revisión personal de informes, sitios de Internet y apuntes personales procedentes de diversos proyectos, reuniones y actividades relacionados con la vigilancia de las enfermedades crónicas en las Américas, y en un análisis a profundidad de los materiales recopilados. Se ha determinado que las agencias sanitarias internacionales, los gobiernos de diversos países, las organizaciones no gubernamentales y los profesionales de la sanidad pública han dedicado grandes esfuerzos a la construcción y al desarrollo de las capacidades de vigilancia de las enfermedades crónicas en la Región. Para seguir apoyando el aumento de dichas capacidades, se hace necesario establecer una red de redes (una metarred) cuya misión debería ser la vigilancia de la vigilancia. Siete aspectos importantes para el aumento de esta capacidad son la estrategia, la colaboración, la información, la educación, la novedad, la comunicación, y la evaluación.

Index code	Element
ti	article title
au	author
kw	article keywords
subject	subject (title words, abstract and keywords)
ab	abstract
ta	journal short title (e.g. Cad. Saúde Pública)
journal_title	journal full title (e.g. Cadernos de Saúde Pública)
la	publication language code (e.g. pt - Portuguese, es - Spanish)
type	document type
pid	publication identifier
publication_year	publication year of publication
sponsor	sponsor
aff_country	country code of the author's affiliation
aff_institution	author affiliation institution
volume	article volume
issue	article issue
elocation	elocation
doi	DOI number
issn	journal ISSN
in	SciELO colection code (e.g. scl - Brasil, col - Colômbia)
use_license	article usage license code

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