No abstract

Repeated OEF and OIF deployments may adversely affect the military readiness of New Jersey National Guard combat soldiers.

CPs provide a wide range of recovery-oriented services and are valued by staff and consumers.

CPs provide a wide range of recovery-oriented services and are valued by staff and consumers.

No abstract

Objective: Few interventions assist individuals with a mental illness and a co-occurring substance abuse disorder in the transition from hospitalization to outpatient treatment. This change in care is often abrupt, resulting in fragmented treatment that jeopardizes recovery. This article reports on the preliminary outcomes from a new eight-week linkage intervention entitled “Time-Limited Case Management (TLC)” that integrates intensive outreach, Dual Recovery Therapy (DRT), and peer support to facilitate outpatient treatment engagement following discharge from Acute Psychiatry. Method: This eight-week naturalistic feasibility study included 59 recently hospitalized subjects with a mental illness and substance abuse disorder who were offered the new service. The individuals who agreed to receive TLC (n = 26) formed the treatment group and those who refused (n = 33) made up the comparison group. Results: The TLC service was successfully implemented into the system and improved the transition from inpatient to outpatient care. The individuals who received the TLC intervention had a higher show rate at the Day Treatment Center intake appointment, attended more days of treatment at the Day Center, had greater pharmacy refill compliance, and were less likely to be lost to follow-up at eight weeks than the comparison group. Conclusion: TLC represents a promising new approach to maintaining continuity in care following psychiatric hospitalization that may be easily implemented in other systems. We are currently in the process of developing an implementation manual and doing a large randomized controlled trial to determine whether the intervention improves substance abuse and psychiatric outcomes in addition to facilitating treatment engagement

-Objective: Individuals with co-occurring psychiatric and substance abuse problems often exhibit poor outpatient treatment engagement and re-hospitalization following discharge from acute psychiatric services. Although case management can improve treatment engagement and reduce attrition, these services are often delivered indefinitely, limiting the availability of treatment slots. In an effort to reduce re-hospitalization rates and improve outcomes during the transition from inpatient to outpatient treatment, we developed and evaluated Time-Limited Case Management (TLC), an eight-week integrated mental health and substance abuse augmentation intervention.Method: Sixty-five dually diagnosed veterans admitted to inpatient psychiatric treatment were included in the program evaluation, 32 who received the TLC service in addition to Treatment as Usual (TAU) that began during inpatient treatment and continued after the transition to outpatient services, and a comparison group of 33 who received only TAU without transitional support provided through the TLC augmentation service.Results: The TLC group had fewer days and episodes of hospitalization at two and six month post-study entry. Furthermore, the TLC group exhibited greater improvements on the Global Assessment of Functioning from baseline to the six-month follow-up.Conclusion: TLC appears to be an effective transitional augmentation service with benefits that persist beyond the eight weeks of the program. Future research should Background and Objectives

Residential programs can improve the lives of homeless individuals, but many participants leave prematurely. Certain characteristics evident upon admission may help to identify those at greatest risk of early discharge. The records of 197 unique admissions to a homeless veterans program were reviewed. Subjects completed a psychosocial assessment, a diagnostic interview, and depression and alcohol use severity screenings. Alcohol use severity, days of abstinence, and an antisocial behavior disorder were significant independent predictors of type of discharge. The overall model accounted for 14.5% of the variance in type of discharge. Targeted interventions may be needed to help veterans at risk of premature discharge to remain engaged in treatment and to assist them in the transition back to the community.