Online Program

Making our way towards “no wrong door”: Latent classes of substance use disorder treatment facilities in the United States

Monday, November 2, 2015

Pia M. Mauro, Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
Ramin Mojtabai, MD, PhD, MPH, Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
background: The SAMHSA “no wrong door” policy underscores the need to provide services for people with co-occurring disorders (COD) in both mental health and substance use disorder (SUD) treatment settings. Over 40% of individuals meeting SUD criteria have a COD. In this study, we assessed the proportion of SUD treatment services that have services needed for COD. 

methods: Using data from 14,056 facilities in the 2012 National Survey of Substance Abuse Treatment Services (N-SSATS), we conducted latent class analyses (LCA) to identify empirically-based clustering. Facility indicators included availability of COD services (e.g. mental health, peer support, COD groups), counseling (e.g. motivational interviewing, cognitive behavioral therapy), and standard practices (e.g. case reviews).

results: LCA indicated a four-class solution as the most parsimonious model with good fit based on fit indices: including: (1) high intensity services (25%) with high probability of endorsing all items; (2) behavioral health services (28%) with lower probability of endorsing non-mental health items; (3) high peer support (20%) with lower probability of endorsing non-peer support items; and (4) low intensity services (27%) with low probability of endorsing all items.

conclusions: Only about half (53%) of facilities were in classes providing behavioral health services. In order to ensure that people with co-occurring behavioral health needs find “no wrong door”, factors acting as facilitators or barriers to incorporating behavioral health services into specialty SUD treatment facilities should be identified.

Learning Areas:

Provision of health care to the public
Public health or related public policy
Social and behavioral sciences

Learning Objectives:
Identify empirically-derived classes of specialty substance use disorder (SUD) treatment facilities in the US. Describe classes of specialty SUD treatment facilities by the probability of endorsing service indicators.

Keyword(s): Drug Abuse Treatment, Treatment Patterns

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a PhD candidate in Drug Dependence Epidemiology at the Johns Hopkins Bloomberg School of Public Health. My research interests include co-occurring behavioral health disorders and health equity.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.