The Influence of Neighborhood Environment on Treatment Continuity and Rehospitalization in Dually Diagnosed Patients Discharged From Acute Inpatient Care

Abstract

A more explicit focus on the neighborhood and community context represents an important area in psychiatry, in terms of both research and clinical practice, which can potentially enhance long-term care and treatment planning for psychiatric patients. Future research is needed to better understand the influence of the neighborhood environment to help predict important clinical outcomes.

A Multilevel Analysis of Regional and Individual Effects on Methadone Maintenance Treatment in Taiwan

“…The findings in this study are consistent with a study by Jacobson [27], who determined that the location of drug treatment facilities might increase client exposure to potential environmental relapse triggers, including neighborhood disadvantage, violence, and drug activity. In addition, this study is partly consistent with that of Stahler et al [16] that determined that participants living in areas of higher education had a reduced likelihood of readmission. Jacobson et al [15] focused on the racial disparities in the relationship between alcohol treatment programs and neighborhood dis- Table 2 -The multiple regression and stepwise-forward multiple regression for individual-and regional-level variables with the improving OTI score (n = 127).…”

“…In addition, Saxe et al [14] indicated that visible drug sales in poor neighborhoods presented a more serious problem than drug use. Few studies have identified neighborhood environment as a factor associated with treatment outcomes [15,16,27]. The findings in this study are consistent with a study by Jacobson [27], who determined that the location of drug treatment facilities might increase client exposure to potential environmental relapse triggers, including neighborhood disadvantage, violence, and drug activity.…”

“…Jacobson [27] and Stahler et al [16] both used bivariate analysis or traditional regression to handle confusion-induced bias of neighborhood-level effect caused by neglecting the individual-level characteristics. Furthermore, the mechanisms underlying the decreased OTI improvement score of disadvantaged regions remain unclear.…”

“…Several studies have determined that social environmental factors affect mental health and drug use [9 -12], and a few have established a relationship between neighborhood poverty and heroin use [11,13,14]. Although limited research considered the neighborhood effects on treatment and intervention outcomes [15,16], no studies have examined the influence of the treatment region on individual behaviors and MMT outcomes.…”

Psychiatric Readmissions in a Community-Based Sample of Patients With Mental Disorders

“…Several patient-related factors are associated with readmission risk, including poor medication adherence (1); substance use disorders (1); a diagnosis of schizophrenia, bipolar disorder, or depression (4); and comorbid medical disorders (5). Homelessness or residence in an institutional setting are social factors associated with psychiatric readmission (2), and previous hospitalizations (6), length of hospital stay (7,8), and lack of adequate postdischarge care for psychiatric and substance use disorders are system-related factors (9).…”