Classifying substance use disorder treatment facilities with co-located mental health services: A latent class analysis approach. (1st June 2016)

• Record Type: Journal Article
• Authors: Mauro, Pia M.; Furr-Holden, C. Debra; Strain, Eric C.; Crum, Rosa M.; Mojtabai, Ramin
• Is Part Of: Drug and alcohol dependence. Volume 163(2016)
• Page Start: 108
• Page End: 115
• Publication Date: 2016-06-01
• Subjects: Substance use disorder -- Treatment -- Co-occurring disorders -- Mental health; Drug abuse -- Periodicals; Alcoholism -- Periodicals; 616.86
• DOI: 10.1016/j.drugalcdep.2016.04.001
• Languages: English
• ISSNs: 0376-8716

Abstract

Highlights: We empirically derived classes of substance use disorder (SUD) treatment facilities. Four classes of facilities emerged using types of services offered. Classes differed by screening services and groups for co-occurring disorders. About half of facilities were in classes with co-located mental health services. Primary focus of the SUD facility alone did not distinguish between classes. Abstract: Background: The Affordable Care Act calls for increased integration and coordination of behavioral health services, as people with co-occurring disorders (CODs), meeting criteria for both substance use and psychiatric disorders, are overrepresented in treatment samples. Nationwide estimates of mental health (MH) service co-location in substance use disorder (SUD) treatment facilities are needed. We empirically derived a multiple-indicator categorization of services for CODs in SUD treatment facilities. Methods: We used latent class analysis to categorize 14, 037 SUD treatment facilities in the United States and territories included in the 2012 National Survey of Substance Abuse Treatment Services. Latent class indicators included MH screening and diagnosis, MH support services, psychiatric medications, groups for CODs, and psychosocial approaches. Multinomial logistic regression compared facility-identified primary focus (i.e., SUD, MH, mix of SUD-MH, and general/other) and other facility characteristics across classes. Results: A four-class solution was chosen with the following classes: Comprehensive MH/COD Services (25%), MH without COD Services (25%), MH Screening Services (21%), and Limited MH Services (29%). The former two classes with co-located MH services were less likely to report a SUD-primary focus than the latter classes reporting only MH screening or Limited MH Services. Only the Comprehensive MH/COD Services class also had a high probability of providing special groups for CODs. Conclusions: Approximately half of SUD treatment facilities were in classes with co-located mental health services, but only a quarter provided comprehensive COD services. Future studies should assess differences in patient experiences and treatment outcomes across facilities with and without COD services.