Using Outcome Data to Improve Treatment Access and Retention

The authors have worked with or at several organizations that have markedly increased access to substance abuse treatment using the NIATx rapid cycle approach. As barriers to access are reduced some of the people who enter treatment are more complex and acute. As census grows, each organization and group of staff ask similar questions: How do we know if we are doing a good job? What if these clients are too disorganized to benefit from treatment?

The Behavior and Symptom Identification Scale (BASIS-24 Copyright; Eisen et al, 2004, 2006) is a brief self-report questionnaire that measures six common presenting symptoms (depression, interpersonal, psychosis, substance abuse, emotional liability, self-harm) among mental health and substance abuse clients.

At the program level, data can be aggregated to create a profile of patient functioning that suggests program focus and/or improvement initiatives. Program changes can be measured for effectiveness, using a rapid cycle approach (one month or less) and correlated with data on access, retention and other key goals. This allows staff to be involved in planning program changes designed to enhance access or retention and to see, in “real” time if the changes are moving the client care outcomes in the desired direction as access and/or retention also shift, thereby answering questions about whether clients benefit from treatment. Examples from several clinical programs in Maine and Connecticut will be used to illustrate this approach.