The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #55885

Sandra M. Gallagher, PhD and Audrey J. Brooks, PhD. La Frontera Center, Inc, 410 S. 6th Ave, Tucson, AZ 85701, 520-594-6316, sgallagher@lafrontera.org

Community Behavioral Health Centers (CBHC) serve a considerable number of multiply diagnosed (substance abuse, mental illness, and chronic medical illness or pain) persons. This understudied population has complex, interacting treatment needs, and higher morbidity/mortality. Higher rates of morbidity and mortality in this population, although well documented, have largely gone unexplored. CBHC clients (232) were surveyed to assess chronic illness and pain, health behaviors, and use of conventional and alternative medical services. Respondents were selected from several different treatment programs (general mental health, serious mental illness, substance abuse outpatient and residential, methadone clinic, and dual diagnosis). Not surprisingly, the results indicate that these clients engage in negative health behaviors such as smoking (73%), high caffeine intake; and many are obese. Interestingly, of the respondents with BMIs of 28 or higher, only 35% indicated obesity as a health issue. Several significant differences were noted between persons reporting symptoms of mental illness (MI) and those reporting substance use only (SA). Specifically, MI reported lower perceived health status, which is a robust predictor of medical utilization, morbidity and mortality. They also report more health problems, more pain sites, and perceived their physical health problems as negatively affecting their mental health. Average pain ratings “best and worst days” were in the range considered treatable. Recommendations for treatment include more attention to physical health and pain as they affect mental health, better coordination between behavioral and medical services, and more emphasis on healthful lifestyle behaviors – wholism in philosophy and practice.

Learning Objectives:

• Recognize high rates of co-morbid mental illness, substance use (including tobacco), and physical health problems.
• Identify potential problematic health behaviors of community behavioral health clients as targets for change.
• Discuss methods to integrate treatment of mental illness, substance use disorders, and physcial health problems in community behavioral health - wholism in practice.

Keywords: Co-morbid, Health Behavior

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.