Purpose: To examine the effectiveness of an academic consultation on outcomes among consumers in a public mental health system and to compare outcomes between high-cost/high-utilizer and midcost consumers.
Methods: Participants (N = 36) completed all questionnaires during three semistructured interviews. Using a repeated-measures experimental design, the outcomes of global functioning, quality of life, service use and need, costs, and consumer satisfaction were examined.
Findings: The hypothesis that consultation would change medication practices and reduce costs was supported.
Conclusions: Consultation with a senior clinician helped change medication practices and reduced costs. Consultation may lead to recognition of a new diagnosis (medical, neurologic, or psychiatric) or suggestions for modifying a treatment regimen that could improve functioning and QOL. In a busy public mental health system, there is often little time for consultation and little thought to second opinions. For clients who cost the system the greatest amount, the small additional cost of a consultation is a good potential investment.