Service use patterns in community mental health outreach: A sequence analysis of the first 12-month longitudinal data

Aims: Community mental health outreach teams offer a range of individualized services tailored to meet the diverse needs of clients. This study aimed to identify service use patterns within community mental health outreach programs using 12-month longitudinal data. Methods: Data from users of the Tokorozawa City mental health outreach service in Japan were analyzed. Service trajectories over a 365-d period were mapped and categorized by primary service type each month. These trajectories were then analyzed using state sequence and clustering methods. The services included 10 categories (i.e., family support and psychiatric symptom management) and cases of no support. We compared the demographic characteristics (e.g., sex, age, living situation, and diagnosis) and reasons for service initiation (e.g., symptom-related life problems, treatment interruption, or untreated conditions) between clusters. Results: The service use trajectories of 70 participants were divided into four clusters. Cluster 1 had a high proportion of psychiatric symptom management services (n = 25). Cluster 2 focused primarily on family support (n = 11). Cluster 3 offered a mix of diverse services (n = 21). Cluster 4 involved inter-agency collaboration and early termination of services (n = 13). Significant differences were found between clusters in terms of sex and some reasons for service initiation. Conclusions: While community mental health outreach programs deliver a broad range of personalized services, we identified four distinct service use patterns over the first 12 months. Given that demographic and clinical characteristics may vary across these patterns, further research with a larger dataset is needed.