Heterogeneity of Co-occurring Disorders: An Outpatient Analysis

With the emergence of public managed care for mental health and substance abuse co-occurring treatment programs, states are being challenged to stretch scarce public funds. Public mental health and substance abuse funding is disproportionate when compared to public expenditures for the same treatment. Researchers and healthcare practitioners have come to realize, in addition to high prevalence rates among Medicaid and Supplemental Security Income beneficiaries, individuals experiencing co-occurring disorders do not represent a homogeneous group. As the concept of co-occurring disorders has evolved, public health social workers understand the need to re-address existing treatment plans and programs that have been traditionally separated between substance abuse and mental health services. It is essential to consider the heterogeneity of co-occurring disorders when considering new treatment plans.

Based on the premise that the level of resources necessary for delivering quality care is directly correlated with knowing and understanding the multiple domains of an illness or disorder, the purpose of the current study was to address a significant void in knowledge on the heterogeneity of co-occurring disorders. Based on this assumption, latent class analysis (LCA) was used to analyze secondary data to determine if subgroups exist within the target population. LCA is a statistical technique that identifies mutually exclusive groups of individuals within a population. Findings indicated three homogenous subgroups existed within an outpatient population (N = 680) seeking integrated treatment for their co-occurring disorders. Such empirically-derived subgroups hold important public health implications for treatment models and service delivery.