AIMS-For a Swedish national sample of 12,833 individuals assessed for a substance use disorder (SUD) (2002-2008) in the Swedish welfare system, client self-report and clinical staff Addiction Severity Index (ASI) assessment data were used to assess mental health problem severity and needs. METHODS-Analysis of client self-report data using regression methods identified demographic characteristics associated with reporting significant mental health problems. Clinical staff assessment data from the ASI Interviewer Severity Rating (ISR) score were used to develop a Kmeans cluster analysis with three client cluster profiles: Narcotics (n=4795); Alcohol (n=4380); and Alcohol and Psychiatric Problems (n=3658). Chi-square and one-way ANOVA analyses identified self-reported mental health problems for these clusters. RESULTS-44% of clients had a history of using outpatient mental health treatment, 45% reported current mental health symptoms, and 19% reported significant mental health problems. Women were 1.6 times more likely to report significant mental health problems than men. Staff assessed that 74.8% of clients had current mental health problems and that 13.9% had significant mental health problems. Client and staff results were congruent in identifying that clients in the Alcohol profile were less likely (5%) to report having significant mental health problems compared to the other two profiles (30% each). CONCLUSIONS-About 19% of clients with SUDs reported significant mental health problems, need integrated addiction and mental health treatment, and these clients are clustered in two population groups. An additional 25% of the addiction treatment population report current mental health symptoms and have at some point used mental health treatment. This national level assessment of the extent and severity of co-occurring disorders can inform decisions made regarding policy shifts towards an integrated system and the needs of clients with co-occurring disorders. KEYWORDS-substance abuse and mental health, integration, substance abuse and mental health treatment, substance abuse and mental health systems, Sweden, addiction prevalence.
In-person interview data from 13,903 individuals assessed for a drug use disorder in the Swedish welfare system from 2002-2008, were analyzed using logistic regression methods. Second generation immigrants with non-Scandinavian parents were 41% more likely to report a history of compulsory treatment compared to those born in Sweden to Swedish parents after controlling for age, gender, education, mental health treatment homeless status history, and criminal justice history. Implications include the need to study acculturation, stigma, and discrimination-related factors as well as to promote culturally competent outreach to immigrant populations.
En klusteranalys av intervjuarskattningar från ASI-intervjuns sju olika livsområden för 12833 klienter visade att klienterna kan delas in i tre olika klientprofiler: Narkotikaprofil, Avgränsade alkoholproblem och Alkohol och psykiska problem. I artikeln jämförs de tre profilerna med avseende på missbruksmönster, demografiska faktorer, sociala och psykiska problem, hälsa och immigrationsstatus.
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