Examination of Referral Source and Retention Among Women in Residential Substance Use Disorder Treatment: A Prospective Follow-Up Study

Abstract Background: Court-mandated substance use disorder (SUD) treatment, as compared to nonmandated treatment, has been associated with increased retention and completion. However, whether child protective services (CPS)-mandated women’s residential SUD treatment leads to improved treatment retention in comparison to criminal justice (CJ)-mandated and nonmandated treatment remains unclear. Purpose: This study compared the number of days retained in residential SUD treatment among three referral sources (CPS, CJ, and nonmandated), while also examining whether having a co-occurring mental health disorder or certain mental health characteristics (increased stress, depression, anxiety, and PTSD symptomology) contributed to decreased retention. This study tested the hypothesis that women mandated by the CPS and CJ systems would have improved residential SUD treatment retention compared with nonmandated women. Methods: Multivariate regression analyses were conducted on data for a diverse sample of 245 women (Hispanic: N = 141, Black: N = 50, White: N = 50) mandated or nonmandated (CJ: N = 114, CPS: N = 82, nonmandated: N = 49) into residential SUD treatment to determine each group’s treatment retention outcomes. Results: Women mandated to SUD residential treatment regardless of source (CPS or CJ) remained in treatment significantly longer (CPS: M = 116.59 days, SD = 65.59, p = .023; CJ: M = 133.86 days, SD = 79.43, p = .028), compared to women not mandated (M = 96.11 days, SD = 72.09), representing a 34.4% and 31.6% increase, respectively. Findings further revealed a corresponding 2.3% decrease in retention (p = .024) for each one-unit increase in a patient’s stress score, whereas those with a co-occurring mental health diagnosis had a 43.6% decrease in SUD treatment retention (p < .001). Conclusions: This study highlights the importance of future research that examines the impact of referral source, co-occurring mental disorders, and stress on women’s residential SUD treatment retention.Further research is needed examining the variability in external motivation among referral sources compounded by dynamic intersections of risk associated with having a co-occurring disorder and stress on treatment retention.ClinicalTrials.gov Identifier: NCT02977988 (first posted November 30, 2016; last update posted October 7, 2019); U.S. NIH Grant/Contract: 5R01DA038648

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Examination of referral source and retention among women in residential substance use disorder treatment: a prospective follow-up study

10.21203/rs.3.rs-78829/v2 ◽

2021 ◽

Author(s):

Dean Rivera ◽

Donna Dueker ◽

Hortensia Amaro

Keyword(s):

Mental Health ◽

Substance Use ◽

Substance Use Disorder ◽

Mental Health Disorder ◽

Treatment Retention ◽

Service Needs ◽

Management Support ◽

Protective Services ◽

Unit Increase ◽

Court Mandated

Abstract Background: Court-mandated substance use disorder (SUD) treatment, as compared to nonmandated treatment, has been associated with increased retention and completion. However, whether child protective services (CPS)-mandated women’s residential SUD treatment leads to improved treatment retention in comparison to criminal justice (CJ)-mandated and nonmandated treatment remains unclear. Purpose: This study compared the number of days retained in residential SUD treatment among three referral sources (CPS, CJ, and nonmandated), while also examining whether having a co-occurring mental health disorder or increased stress, depression, anxiety, and PTSD symptomology contributed to decreased retention. This study tested the hypothesis that women mandated by the CPS and CJ systems would have improved residential SUD treatment retention compared with nonmandated women. Methods: Multiple regression analyses were conducted on data for a diverse sample of 245 women (Hispanic: N = 141, Black: N = 50, White: N = 50) mandated or nonmandated (CJ: N = 114, CPS: N = 82, nonmandated: N = 49) into residential SUD treatment to determine each group’s treatment retention outcomes. Results: Women mandated to SUD residential treatment by the CPS system remained in treatment significantly longer ( p = .046), compared to women not mandated, representing a 34.4% increase in retention. Findings further revealed a corresponding 2.3% decrease in retention ( p = .048) for each one-unit increase in a patient’s stress score, whereas those with a co-occurring mental health diagnosis had a 43.6% decrease in SUD treatment retention ( p < .001). Conclusions: Policy and clinical considerations include (a) increasing case management support and wraparound services that meet the multiple service needs of women who are nonmandated to residential SUD treatment, and (b) incorporating a more nuanced treatment approach that manages mental health disorders and stress symptomology early in treatment when women are most vulnerable to relapse and treatment dropout. ClinicalTrials.gov Identifier: NCT02977988 (first posted November 30, 2016; last update posted October 7, 2019); U.S. NIH Grant/Contract: 5R01DA038648

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Examination of referral source and retention among women in residential substance use disorder treatment: a prospective follow-up study

Substance Abuse Treatment Prevention and Policy ◽

10.1186/s13011-021-00357-y ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Dean Rivera ◽

Donna Dueker ◽

Hortensia Amaro

Keyword(s):

Mental Health ◽

Substance Use ◽

Substance Use Disorder ◽

Mental Health Disorder ◽

Treatment Retention ◽

Service Needs ◽

Management Support ◽

Protective Services ◽

Link Type ◽

Court Mandated

Abstract Background Court-mandated substance use disorder (SUD) treatment, as compared to nonmandated treatment, has been associated with increased retention and completion. However, whether child protective services (CPS)-mandated women’s residential SUD treatment leads to improved treatment retention in comparison to criminal justice (CJ)-mandated and nonmandated treatment remains unclear. Purpose This study compared the number of days retained in residential SUD treatment among three referral sources (CPS, CJ, and nonmandated), while also examining whether having a co-occurring mental health disorder or increased stress, depression, anxiety, and PTSD symptomology contributed to decreased retention. This study tested the hypothesis that women mandated by the CPS and CJ systems would have improved residential SUD treatment retention compared with nonmandated women. Methods Multiple regression analyses were conducted on data for a diverse sample of 245 women (Hispanic: N = 141, Black: N = 50, White: N = 50) mandated or nonmandated (CJ: N = 114, CPS: N = 82, nonmandated: N = 49) into residential SUD treatment to determine each group’s treatment retention outcomes. Results: Women mandated to SUD residential treatment by the CPS system remained in treatment significantly longer (p = .046), compared to women not mandated, representing a 34.4% increase in retention. Findings further revealed a corresponding 2.3% decrease in retention (p = .048) for each one-unit increase in a patient’s stress score, whereas those with a co-occurring mental health diagnosis had a 43.6% decrease in SUD treatment retention (p < .001). Conclusions Policy and clinical considerations include (a) increasing case management support and wraparound services that meet the multiple service needs of women who are nonmandated to residential SUD treatment, and (b) incorporating a more nuanced treatment approach that manages mental health disorders and stress symptomology early in treatment when women are most vulnerable to relapse and treatment dropout. Trial registration ClinicalTrials.gov Identifier: NCT02977988 (first posted November 30, 2016; last update posted October 7, 2019); U.S. NIH Grant/Contract: 5R01DA038648.

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Opportunities to Integrate Mobile App–Based Interventions Into Mental Health and Substance Use Disorder Treatment Services in the Wake of COVID-19

American Journal of Health Promotion ◽

10.1177/08901171211055314 ◽

2021 ◽

pp. 089011712110553

Author(s):

Derek D. Satre ◽

Meredith C. Meacham ◽

Lauren D. Asarnow ◽

Weston S. Fisher ◽

Lisa R. Fortuna ◽

...

Keyword(s):

Mental Health ◽

Substance Use ◽

Substance Use Disorder ◽

Mental Health Problems ◽

Mobile Apps ◽

Mobile App ◽

Future Research ◽

Substance Use Disorder Treatment ◽

Disorder Treatment ◽

The Impact

The COVID-19 pandemic has heightened concerns about the impact of depression, anxiety, alcohol, and drug use on public health. Mobile apps to address these problems were increasingly popular even before the pandemic, and may help reach people who otherwise have limited treatment access. In this review, we describe pandemic-related substance use and mental health problems, the growing evidence for mobile app efficacy, how health systems can integrate apps into patient care, and future research directions. If equity in access and effective implementation can be addressed, mobile apps are likely to play an important role in mental health and substance use disorder treatment.

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The impact of substance use disorder on the mental health among COVID-19 patients

Medicine ◽

10.1097/md.0000000000023203 ◽

2020 ◽

Vol 99 (46) ◽

pp. e23203

Author(s):

Yun Jin Kim ◽

Linchao Qian ◽

Muhammad Shahzad Aslam

Keyword(s):

Mental Health ◽

Substance Use ◽

Substance Use Disorder ◽

The Impact

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Assessing Comorbidities and service use among patients with benzodiazepine abuse

European Psychiatry ◽

10.1016/j.eurpsy.2016.01.1003 ◽

2016 ◽

Vol 33 (S1) ◽

pp. S294-S294 ◽

Cited By ~ 1

Author(s):

B. Cook ◽

L. Chavez ◽

R. Carmona ◽

M. Alegria

Keyword(s):

Mental Health ◽

Mental Illness ◽

Substance Use ◽

Substance Use Disorder ◽

Regression Models ◽

Service Use ◽

Safety Net ◽

Mental Health Disorder ◽

Electronic Health Record Data ◽

Competing Interest

Prior studies have identified that individuals with comorbid substance use disorder and mental health disorder are at a greater risk of benzodiazepine abuse compared to individuals that present with mental health disorder without an accompanying substance use disorder. These studies were conducted in predominantly white populations, and little is known if the same associations are seen in safety net health care networks. Also, the literature is mixed as to whether or not psychiatrists’ prescription of benzodiazepines places individuals at undue risk of benzodiazepine abuse.We use 2013–2015 electronic health record data from a Boston healthcare system. Patients with benzodiazapene abuse were identified if they had received treatment under the ICD-9 code 304.1. Benzodiazepine abuse was compared between patients with only mental illness and patients with existing comorbid substance and mental health disorder, in unadjusted comparisons and adjusted regression models. Covariates in regression models were used to identify subgroups at higher risk of benzodiazepine abuse.Individuals with benzodiazepine abuse had higher rates of emergency room and inpatient use than patients with other mental health and/or substance use disorders. Those with comorbid substance and mental disorder were significantly more likely than individuals with mental or substance use disorder alone to abuse benzodiazepines (P < .01). Among those with benzodiazepine abuse, 93.3% were diagnosed with a mental illness, 75.6% were diagnosed with a substance use disorder (other than benzodiazepine), and 64.4% had comorbid anxiety disorder and substance use disorder. These analyses suggest that patients with benzodiazepine abuse have complex presentations and intensive service use.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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The impact of substance use on treatment as a compulsory patient

Australasian Psychiatry ◽

10.1177/1039856219852286 ◽

2019 ◽

Vol 27 (4) ◽

pp. 378-382

Author(s):

Ruth Vine ◽

Holly Tibble ◽

Jane Pirkis ◽

Matthew Spittal ◽

Fiona Judd

Keyword(s):

Mental Health ◽

Substance Use ◽

Substance Use Disorder ◽

Inpatient Treatment ◽

Subsequent Treatment ◽

Community Treatment ◽

Main Diagnosis ◽

The Impact ◽

Treatment Order ◽

Community Treatment Order

Objectives: This paper considers the impact of having a diagnosis of substance use disorder on the utilisation of compulsory orders under the Victorian Mental Health Act (2014). Methods: We analysed the subsequent treatment episodes over 2 years of people who had been on a community treatment order for at least 3 months and determined the odds of a further treatment order if there was a diagnosis of substance use at or about the time the index community treatment order ended. Results: An additional diagnosis of a substance use disorder was coded in 47.7% and was associated with significantly increased odds of a subsequent treatment order in the following 2 years for those with a main diagnosis of schizophrenia (AOR = 3.03, p<0.001) and ‘other’ disorders (AOR = 11.60, p=0.002). Those with a main diagnosis of mood disorder had a significant increase in odds for an inpatient treatment order if there was an additional substance use disorder diagnosis (AOR = 3.81, p=0.006). Conclusions: Having an additional diagnosis of substance use disorder was associated with increased likelihood of being placed on an order. This study supports greater emphasis being given to treatment of substance use concurrently with that of mental illness.

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Why They Did It? Sex Differences in the Impact of Mental Health and Substance Use on Motivations for Offending

Crime & Delinquency ◽

10.1177/0011128717718489 ◽

2017 ◽

Vol 64 (6) ◽

pp. 723-757 ◽

Cited By ~ 3

Author(s):

Jessica M. Craig ◽

Angie D. Wilson ◽

Michael T. Baglivio ◽

Kevin T. Wolff ◽

Alex R. Piquero ◽

...

Keyword(s):

Mental Health ◽

Substance Use ◽

Multinomial Logistic Regression ◽

Future Research ◽

Health Issues ◽

Community Based ◽

Adjudicated Youth ◽

Logistic Regression Models ◽

Mental Health Issues ◽

The Impact

This study examined how mental health issues and substance use relate to motivations for offending among a large sample of adjudicated youth who completed a community-based placement in a large southeastern state ( n = 18,749). The extent to which these relationships differed by sex was also considered. Multinomial logistic regression models revealed that although both mental health issues and substance use were related to a variety of reasons for offending, these relationships differed and did not appear to influence one another. In addition, findings revealed that mental health issues and substance use have differential effects on reasons for offending across sex. Treatment implications are highlighted along with suggestions for future research.

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Measuring the burden of mental illness and substance use and the level and impact of health care response in patients with spinal trauma: a record linkage study.

International Journal for Population Data Science ◽

10.23889/ijpds.v4i3.1218 ◽

2019 ◽

Vol 4 (3) ◽

Author(s):

Lisa Sharwood ◽

Bharat Vaikuntam ◽

Ashley Craig ◽

James Middleton ◽

Jesse Young

Keyword(s):

Mental Health ◽

Mental Illness ◽

Substance Use ◽

Social Work ◽

Acute Care ◽

Substance Use Disorder ◽

Record Linkage ◽

Recurrent Event ◽

Self Harm ◽

The Impact

Background with rationale Traumatic spinal injuries (TSI) include column fractures, spinal cord injury, or both. They are among the most severe injuries with potential long-term physical, psychological, and social consequences. Primary causes of TSIs are falls and motor vehicle crashes, however, mental illness and substance use are known to significantly increase all injury risk. Injury is also known to increase risks of mental deterioration and physical complications including self-harm and self-neglect. Main Aim We aimed to identify comorbid mental illness and/or substance use at incident TSI, quantifying associated costs and health service management of these inequities. Methods NSW record-linkage administrative data analyses (2013-2016) will determine accurate prevalence of mental illness and/or substance use disorder among all patients who sustained acute TSI during the study period. Using recurrent event analyses, we will estimate the contributions of mental illness and/or substance use disorder on the impact on hospital acquired complications (HAC), length of stay and costs; assessing records for social work and/or psychologist consultation. Results 13,489 individuals were hospitalised with acute TSI; 21% had either mental health and/or substance use diagnoses; 8.7% had both. These patients were more likely to have experienced falls or intentional self-harm, be male and have multiple comorbidity. Acute care stay and costs were on average twice that of patients with TSI without mental health and/or substance use diagnoses; additionally they were more than twice as likely to experience HACs. Only 56% of TSI patients with these comorbid conditions in the context of TSI, had documented social work or psychologist consultation. Conclusion Patients with mental illness and/or substance use disorder, experience significant health disparities that require concerted health system attention that should begin early in acute care.

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