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APHA Scientific Session and Event Listing

Recorded presentation

Katherine R. Disare, BA, School of Public Health, State University of New York at Albany, 39 Hazen St., Cornwall, NY 12518, (845) 534-3549, kdisare@gmail.com and John A. Hornik, PhD, Research and Evaluation Center, Advocates for Human Potential, Two E-Comm Square, 324 Broadway, Albany, NY 12207.

Recovering from an addiction is a challenging task, made even more difficult when burdened with a co-occurring psychiatric disorder. Dual diagnoses are highly prevalent among clients in methadone maintenance programs, the subject of this study. This research compared parallel and integrated approaches on the effectiveness of treatment for both disorders. Mental health treatment was provided by a separate agency in the parallel approach, whereas the integrated approach incorporated it within the same program. Data were collected through client interviews over a one year period, with clients sampled based on length of stay (n=281). After controlling for pre-existing population differences between the programs, mixed regression was employed with program type, time, and length of stay as predictors, with interactions. Outcomes examined included substance use, mental health, physical health, and legal problems.

The prevalence of a co-occurring psychiatric disorder was over 75% in both programs. The integrated program was better at both identifying those with a mental disorder (sensitivity using MINI, Integrated: 86%, Parallel: 53%) and providing mental health treatment for those with such a diagnosis (% of clients receiving medication at baseline: Integrated=68%, Parallel=46%). In addition, results from mixed regression analyses indicated more favorable outcomes for the integrated program on frequency of substance use, mental distress, and somatic symptoms. These results indicate that clients with co-occurring disorders in the integrated program will have more favorable treatment outcomes over time than those in the parallel program, suggesting a need for the integration of mental health and substance abuse treatment systems.

Learning Objectives: At the conclusion of this presentation, participants will be able to do the following

• Understand the differences between integrated and parallel treatment of co-occurring disorders;
• Understand the effects of service organization on identification of co-occurring mental health disorders within substance abuse programs.
• Understand the effects of service organization on access to mental health treatment of persons in substance abuse programs.
• Understand the effects of service organization on outcomes of treatment for co-occuring mental health and substance abuse disorders.

Keywords: Treatment Outcomes, Methadone Maintenance

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation