A brief community linkage intervention for veterans with a persistent mental illness and a co-occurring substance abuse disorder

Abstract

-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

Integrating a Co-occurring Disorders Intervention in Drug Courts: An Open Pilot Trial

“…MISSION-CJ was adapted from our wraparound approach called MISSION, originally developed to help clients with a co-occurring mental health and substance abuse problem engage in community supports while simultaneously addressing some of their clinical needs, and has recently been included in the Substance Use and Mental Health Services National Registry for Evidence Based Practices (Smelson et al 2007;MISSION 2016). Our previous research has shown MISSION to improve mental health, substance use, housing, and employment outcomes for homeless clients as well as veterans (Smelson et al 2012(Smelson et al , 2013(Smelson et al , 2015.…”

An Alternative to Incarceration: Co-Occurring Disorders Treatment Intervention for Justice-Involved Veterans

“…MISSION‐CJ grew out of our previously developed time‐limited, case management approach called MISSION‐VET, which was designed to meet the diverse needs of homeless veterans with CODs (Smelson, Sawh, Kane, et al, ; Smelson, Sawh, Rodrigues, et al, ). Our previous research on MISSION‐VET suggested that it was effective in improving substance use, housing, and employment outcomes for veterans (Smelson et al, , , , ). Therefore, MISSION‐VET provided an optimal starting point to facilitate the development of an integrated second‐generation, veteran‐centric, criminal justice intervention for justice‐involved veterans as it had many of the same treatment key components to address the offender population with co‐occurring disorders.…”

Improving Substance Use Care: Addressing Barriers to Expanding Integrated Treatment Options for Post-9/11 Veterans

“…Maintaining Independence and Sobriety Through Systems Integration, Outreach, and Networking (MISSION) is a 12-month wraparound program developed for veterans with co-occurring disorders. It consists of Dual Recovery Therapy, a manualized treatment for co-occurring disorders that includes elements of relapse prevention, social skills training, 12-step programs, and MET; Critical Time Intervention; and peer support (Smelson et al, 2007). MISSION is delivered by a case manager and peer specialist and is designed to support veterans as they transition from residential to outpatient care (Smelson et al, 2013).…”