Decreases in inpatient hospitalisations from a technology-based, integrated behavioural health crisis response system: an evaluation of the Grand Response Access Network on Demand (GRAND) Model

ABSTRACT Objective: In the US, there is a need for integrated behavioural health crisis programs that can offer alternatives to inpatient placements and improve client outcomes. In response, GRAND Mental Health in Oklahoma developed the Grand Response Access Network on Demand Model (GRAND Model) in 2016. The purpose of this research was to evaluate the GRAND Model’s outcomes and establish the evidence that it reduces inpatient placements. Methodology: A longitudinal research design using secondary data was used to assess outcomes before and after the GRAND Model implementation in 2016. Quantitative data-informed changes in the central outcome of interest: reductions in inpatient hospitalisations. Results: From 2015 to 2021, the number of inpatient hospitalisations among GRAND adult clients at any Oklahoma psychiatric hospital (excluding Wagoner) fell from 959 (2015) to 66 (2021), a reduction of 93.1%. Inpatient hospitalisations among GRAND adult clients at Wagoner Hospital fell from 841 (2015) to 0 (2021), a reduction of 100%. Discussion: The findings presented here suggest that the GRAND Model could be effective in reducing inpatient hospitalisations among adults. Replication of the model is encouraged by other communities, particularly those in rural areas.