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Classifying substance use disorder treatment facilities with co-located mental health services: A latent class analysis approach.
Drug Alcohol Depend. 2016 Jun 01; 163:108-15.DA

Abstract

BACKGROUND

The Affordable Care Act calls for increased integration and coordination of behavioral health services, as people with co-occurring disorders (CODs), meeting criteria for both substance use and psychiatric disorders, are overrepresented in treatment samples. Nationwide estimates of mental health (MH) service co-location in substance use disorder (SUD) treatment facilities are needed. We empirically derived a multiple-indicator categorization of services for CODs in SUD treatment facilities.

METHODS

We used latent class analysis to categorize 14,037 SUD treatment facilities in the United States and territories included in the 2012 National Survey of Substance Abuse Treatment Services. Latent class indicators included MH screening and diagnosis, MH support services, psychiatric medications, groups for CODs, and psychosocial approaches. Multinomial logistic regression compared facility-identified primary focus (i.e., SUD, MH, mix of SUD-MH, and general/other) and other facility characteristics across classes.

RESULTS

A four-class solution was chosen with the following classes: Comprehensive MH/COD Services (25%), MH without COD Services (25%), MH Screening Services (21%), and Limited MH Services (29%). The former two classes with co-located MH services were less likely to report a SUD-primary focus than the latter classes reporting only MH screening or Limited MH Services. Only the Comprehensive MH/COD Services class also had a high probability of providing special groups for CODs.

CONCLUSIONS

Approximately half of SUD treatment facilities were in classes with co-located mental health services, but only a quarter provided comprehensive COD services. Future studies should assess differences in patient experiences and treatment outcomes across facilities with and without COD services.

Authors+Show Affiliations

Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Baltimore, MD 21205, USA; Department of Epidemiology, Columbia University Mailman School of Public Health, 722 W 168th Street, New York, NY 10032, USA. Electronic address: pm2838@cumc.columbia.edu.Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Baltimore, MD 21205, USA. Electronic address: cfurrho1@jhu.edu.Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, 733 N. Broadway, Baltimore, MD 21205, USA. Electronic address: estrain1@jhmi.edu.Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St., Baltimore, MD 21205, USA; Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Baltimore, MD 21205, USA. Electronic address: rcrum1@jhu.edu.Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Baltimore, MD 21205, USA; Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, 733 N. Broadway, Baltimore, MD 21205, USA. Electronic address: rmojtab1@jhu.edu.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27106113

Citation

Mauro, Pia M., et al. "Classifying Substance Use Disorder Treatment Facilities With Co-located Mental Health Services: a Latent Class Analysis Approach." Drug and Alcohol Dependence, vol. 163, 2016, pp. 108-15.
Mauro PM, Furr-Holden CD, Strain EC, et al. Classifying substance use disorder treatment facilities with co-located mental health services: A latent class analysis approach. Drug Alcohol Depend. 2016;163:108-15.
Mauro, P. M., Furr-Holden, C. D., Strain, E. C., Crum, R. M., & Mojtabai, R. (2016). Classifying substance use disorder treatment facilities with co-located mental health services: A latent class analysis approach. Drug and Alcohol Dependence, 163, 108-15. https://doi.org/10.1016/j.drugalcdep.2016.04.001
Mauro PM, et al. Classifying Substance Use Disorder Treatment Facilities With Co-located Mental Health Services: a Latent Class Analysis Approach. Drug Alcohol Depend. 2016 Jun 1;163:108-15. PubMed PMID: 27106113.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Classifying substance use disorder treatment facilities with co-located mental health services: A latent class analysis approach. AU - Mauro,Pia M, AU - Furr-Holden,C Debra, AU - Strain,Eric C, AU - Crum,Rosa M, AU - Mojtabai,Ramin, Y1 - 2016/04/07/ PY - 2015/08/18/received PY - 2016/03/29/revised PY - 2016/04/03/accepted PY - 2016/4/24/entrez PY - 2016/4/24/pubmed PY - 2017/10/11/medline KW - Co-occurring disorders KW - Mental health KW - Substance use disorder KW - Treatment SP - 108 EP - 15 JF - Drug and alcohol dependence JO - Drug Alcohol Depend VL - 163 N2 - BACKGROUND: The Affordable Care Act calls for increased integration and coordination of behavioral health services, as people with co-occurring disorders (CODs), meeting criteria for both substance use and psychiatric disorders, are overrepresented in treatment samples. Nationwide estimates of mental health (MH) service co-location in substance use disorder (SUD) treatment facilities are needed. We empirically derived a multiple-indicator categorization of services for CODs in SUD treatment facilities. METHODS: We used latent class analysis to categorize 14,037 SUD treatment facilities in the United States and territories included in the 2012 National Survey of Substance Abuse Treatment Services. Latent class indicators included MH screening and diagnosis, MH support services, psychiatric medications, groups for CODs, and psychosocial approaches. Multinomial logistic regression compared facility-identified primary focus (i.e., SUD, MH, mix of SUD-MH, and general/other) and other facility characteristics across classes. RESULTS: A four-class solution was chosen with the following classes: Comprehensive MH/COD Services (25%), MH without COD Services (25%), MH Screening Services (21%), and Limited MH Services (29%). The former two classes with co-located MH services were less likely to report a SUD-primary focus than the latter classes reporting only MH screening or Limited MH Services. Only the Comprehensive MH/COD Services class also had a high probability of providing special groups for CODs. CONCLUSIONS: Approximately half of SUD treatment facilities were in classes with co-located mental health services, but only a quarter provided comprehensive COD services. Future studies should assess differences in patient experiences and treatment outcomes across facilities with and without COD services. SN - 1879-0046 UR - https://www.unboundmedicine.com/medline/citation/27106113/Classifying_substance_use_disorder_treatment_facilities_with_co_located_mental_health_services:_A_latent_class_analysis_approach_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0376-8716(16)30013-8 DB - PRIME DP - Unbound Medicine ER -