CORE Posters Fall 2025

The Community Cost of Stability: Evaluating the Effectiveness of PSR and MHCSS Compared to Psychiatric Hospitalization in Roanoke, VA Aquije D. 1* , Burkett B. 1* , Chalamalasetty V. 1* , Elassal M. 1* , Keith A. 1* , McBride P. 1* , Sivanandan N. 1* , McCauley-Wittl C. 2 , Nicholson, J. 1 , Kadio, B. 1 1 Edward Via College of Osteopathic Medicine, Blacksburg, Virginia *Preventive Medicine Group O 2 Roanoke Resource, LLC, Roanoke, Virginia

Introduction

Discussion

Results

Key Findings : • Our analysis suggests that both MHSS and PSR are associated with r elatively low hospitalization rates , particularly among clients engaged in both services. This supports the premise that community-based mental health models may provide effective stabilization for individuals with chronic psychiatric conditions. • Although clear trends emerged in age and length of service, interpretation is limited by incomplete engagement data, unknown hospitalization causes, and lack of subgroup analysis by diagnosis. Strengths : • Engaged ECEs, practical content, virtual format, iterative feedback Limitations : • Small sample size and short project timeline • No direct cost comparison available for hospitalization vs. MHSS/PSR • Hospitalization data not consistently linked to diagnoses or service timelines • No data on session attendance or treatment adherence Future Implications : • Incorporate Medicaid billing data and EMR integration

Methods • Problem: Mental health is a growing concern in Roanoke, Virginia, where nearly half of surveyed households cite mental health as a top concern. The region faces critical shortages in mental health providers , with over 40% of residents considered underserved 1 . Across Virginia, 93 of 133 localities are federally designated mental health professional shortage areas, leaving about 37% of Virginians without adequate access to behavioral health services 2 . Suicide and overdose rates exceed national averages 3 , while depression among Medicare beneficiaries also trends higher than the U.S. norm 4,5,6 . Despite a post-COVID expansion in community-based services, barriers remain. • Solution: Community-based mental health programs such as Psychosocial Rehabilitation (PSR) and Mental Health Community Support Services (MHCSS) aim to reduce hospitalizations, help clients build coping skills, and promote long term stability. Yet their comparative effectiveness to traditional psychiatric hospitalization remains understudied. This project evaluates whether PSR and MHSS can improve outcomes and reduce costs when used as alternatives to frequent inpatient care, especially in underserved populations. • A retrospective chart review was conducted through Roanoke Resource, a community mental health agency. Patient cohorts were identified from MHCSS and PSR programs (n=39 and n=25, respectively), with additional data on overlapping service users and hospitalization history. Key variables included age, gender, diagnosis, number of psychiatric hospitalizations (past 12 months), and length of program participation. • Descriptive and comparative statistical analysis was performed to determine: ○ Rehospitalization frequency ○ Diagnostic subgroup stratification ○ Demographics of clients

Figure 1. Primary diagnoses of individuals in the MHCSS, PSR, and Mixed programs.

• Explore policy implications for reimbursement • Stratify by diagnosis and treatment intensity

Conclusion

This pilot study provides an introductory evaluation of community-based mental health programs in Roanoke, VA. While definitive cost comparisons and detailed subgroup analyses were not possible within project timeline, preliminary results indicate the PSR & MHSS may reduce hospitalizations and support patient stability . Future research with expanded datasets, cost analysis, and stratification by diagnosis, will be critical to determine whether these services can be sustainable and cost-effective alternatives to inpatient psychiatric care.

Figure 2. Hospitalization rate spanning MHCSS, PSR and mixed programs

Acknowledgements

References

We would like to thank Roanoke Resource for their collaboration and ongoing commitment to mental health care. Special thanks to Dr. Bernard Kadio, Jessica Nicholson, Celia McCauley-Wittl, and the Preventive Medicine Research team at VCOM for their support and guidance throughout this project.

Figure 3. L ength of service across all three program types