Factors That Affect Treatment Initiation Among Individuals With Serious Mental Illness and Substance Abuse Disorder

Abstract

Introduction:Studies have shown that approximately half of individuals with mental health disorders have a comorbid drug and alcohol diagnosis. Enrolling dually diagnosed patients in outpatient treatment programs has been a unique challenge for decades. Research identifying factors associated with patient treatment initiation has been limited. Clinicians have suspected that certain drugs, such as methamphetamine, may be a deterrent to treatment initiation. We wanted to identify factors that might be associated with the initiation of dually diagnosed patients in our outpatient dual diagnosis treatment program. Materials and Methods:Data for this study were obtained by retrospective review of 165 consecutive patient charts located in the Harbor-UCLA Dual Diagnosis Treatment Program during the fall of 2011. The factors we examined were age, sex, ethnicity, marital status, education, number of dependents, living situation, employment status, number of hospitalizations, substance abuse/psychiatric treatment background, previous suicide attempts, current medication, diagnosis, specific drug use history and legal history. The dependent variable in this study was treatment initiation. Results:On the basis of our chart review, we found 102 (62%) intake patients subsequently initiated treatment. After backward selection, 2 variables remained as independent predictors in the multivariate model: previous substance abuse treatment and history of methamphetamine use. Discussion:We found that previous substance abuse treatment and previous methamphetamine use were 2 significant predictor variables for initiation into our treatment program. Other possible factors such as sedative/hypnotic use in last 6 months, and alcohol use may also be significant factors in treatment initiation.

A sanctuary of safety: A study of how patients with dual diagnosis experience caring conversations

“…), factors that affect treatment initiation (McClean et al . ), and predictors of change (Bennett et al . ) and aftercare treatment adherence (Pantalon et al .…”

“…We found a few studies that focussed on patients with a dual diagnosis in outpatient settings. These studies were quantitative, describing the benefits of shifting the locus of acute treatment from hospital to community care (Timko et al 2006), factors that affect treatment initiation (McClean et al 2013), and predictors of change (Bennett et al 2012) and aftercare treatment adherence (Pantalon et al 2014). None of them focussed on nurse-patient interactions or conversations.…”

Patterns and temporal change of psychopathological symptoms among inpatients with alcohol use disorder undergoing a twelve-step based treatment

“…Further studies, with more precise methodological design, are warranted to provide evidence whether structured, more intensive, and community-based residential treatment forms that facilitate twelve-step involvement can contribute to beneficial outcomes among AUD patients with more severe psychopathological symptomatic profiles ( Karriker-Jaffe, Klinger, Witbrodt, & Kaskutas, 2018 ). Previous studies have suggested that integrated treatment forms, which simultaneously address AUD-related and psychological-related impairments might have beneficial effects among patients with comorbid AUD and psychiatric disorders ( McClean, Anspikian, Winters, & Tsuang, 2014 ). Interventions which combined treatment approaches focusing on AUD and co-occurring psychiatric disorders were used to facilitate simultaneous improvements in symptomatology of AUD as well as comorbid disorders.…”

Associations between alcohol use-related outcomes and psychopathological symptoms: person- and variable-oriented approaches

“…Further studies, with more precise methodological design, are warranted to provide evidence whether structured, more intensive, and community-based residential treatment forms that facilitate twelve-step involvement can contribute to beneficial outcomes among AUD patients with more severe psychopathological symptomatic profiles (Karriker-Jaffe et al, 2018). Previous studies have suggested that integrated treatment forms, which simultaneously address AUD-related and psychological-related impairments might have beneficial effects among patients with comorbid AUD and psychiatric disorders (McClean et al, 2014). Interventions which combined treatment approaches focusing on AUD and co-occurring psychiatric disorders were used to facilitate simultaneous improvements in symptomatology of AUD as well as comorbid disorders.…”