TY - JOUR
T1 - Classifying substance use disorder treatment facilities with co-located mental health services
T2 - A latent class analysis approach
AU - Mauro, Pia M.
AU - Furr-Holden, C. Debra
AU - Strain, Eric C.
AU - Crum, Rosa M.
AU - Mojtabai, Ramin
N1 - Funding Information:
Dr. Mauro and Dr. Furr-Holden received funding from the National Institute on Drug Abuse ( NIDA; T32DA007292 ). Dr. Strain received funding from NIDA ( K24DA023186 ). Dr. Mauro currently receives funding from NIDA ( T32DA031099 ).
Publisher Copyright:
© 2016 Elsevier Ireland Ltd.
PY - 2016/6/1
Y1 - 2016/6/1
N2 - Background: The Affordable Care Act calls for increased integration and coordination of behavioral health services, as people with co-occurring disorders (CODs), meeting criteria for both substance use and psychiatric disorders, are overrepresented in treatment samples. Nationwide estimates of mental health (MH) service co-location in substance use disorder (SUD) treatment facilities are needed. We empirically derived a multiple-indicator categorization of services for CODs in SUD treatment facilities. Methods: We used latent class analysis to categorize 14,037 SUD treatment facilities in the United States and territories included in the 2012 National Survey of Substance Abuse Treatment Services. Latent class indicators included MH screening and diagnosis, MH support services, psychiatric medications, groups for CODs, and psychosocial approaches. Multinomial logistic regression compared facility-identified primary focus (i.e., SUD, MH, mix of SUD-MH, and general/other) and other facility characteristics across classes. Results: A four-class solution was chosen with the following classes: Comprehensive MH/COD Services (25%), MH without COD Services (25%), MH Screening Services (21%), and Limited MH Services (29%). The former two classes with co-located MH services were less likely to report a SUD-primary focus than the latter classes reporting only MH screening or Limited MH Services. Only the Comprehensive MH/COD Services class also had a high probability of providing special groups for CODs. Conclusions: Approximately half of SUD treatment facilities were in classes with co-located mental health services, but only a quarter provided comprehensive COD services. Future studies should assess differences in patient experiences and treatment outcomes across facilities with and without COD services.
AB - Background: The Affordable Care Act calls for increased integration and coordination of behavioral health services, as people with co-occurring disorders (CODs), meeting criteria for both substance use and psychiatric disorders, are overrepresented in treatment samples. Nationwide estimates of mental health (MH) service co-location in substance use disorder (SUD) treatment facilities are needed. We empirically derived a multiple-indicator categorization of services for CODs in SUD treatment facilities. Methods: We used latent class analysis to categorize 14,037 SUD treatment facilities in the United States and territories included in the 2012 National Survey of Substance Abuse Treatment Services. Latent class indicators included MH screening and diagnosis, MH support services, psychiatric medications, groups for CODs, and psychosocial approaches. Multinomial logistic regression compared facility-identified primary focus (i.e., SUD, MH, mix of SUD-MH, and general/other) and other facility characteristics across classes. Results: A four-class solution was chosen with the following classes: Comprehensive MH/COD Services (25%), MH without COD Services (25%), MH Screening Services (21%), and Limited MH Services (29%). The former two classes with co-located MH services were less likely to report a SUD-primary focus than the latter classes reporting only MH screening or Limited MH Services. Only the Comprehensive MH/COD Services class also had a high probability of providing special groups for CODs. Conclusions: Approximately half of SUD treatment facilities were in classes with co-located mental health services, but only a quarter provided comprehensive COD services. Future studies should assess differences in patient experiences and treatment outcomes across facilities with and without COD services.
KW - Co-occurring disorders
KW - Mental health
KW - Substance use disorder
KW - Treatment
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U2 - 10.1016/j.drugalcdep.2016.04.001
DO - 10.1016/j.drugalcdep.2016.04.001
M3 - Article
C2 - 27106113
AN - SCOPUS:84963804392
SN - 0376-8716
VL - 163
SP - 108
EP - 115
JO - Drug and alcohol dependence
JF - Drug and alcohol dependence
ER -