Mental Health Indicator Interaction and Substance Abuse Treatment Outcomes in Nevada

For clients with co-occurring mental health and substance abuse problems the optimum set of treatment outcome predictors has yet to be found. From the Nevada substance abuse treatment program, client admission and discharge record were reviewed from 1995-2001 (n=17,591). Two indicators of co-occurring mental health problems - a dual diagnosis and a State of Nevada mental health/retardation (cognitive impairment) agency referral - were compared as outcome predictors. Using logistic regression analysis both treatment completion with significant improvement in functioning (33%) and a readmission to treatment following discharge (21%) were predicted, while controlling for other admission variables. Similarly, Cox regression was used to predict a third outcome, the number of days from discharge to treatment readmission. Neither mental health indicator alone significantly predicted any of the three outcomes. Yet, the interaction between the two indicators significantly predicted each of the three outcomes (p<.05). Having both indices was highly associated with physical/sexual abuse, domestic violence, being homeless, out of labor force and prior treatment. Indicator interactions may help improve the prediction of substance abuse treatment outcomes.