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

Abstract #60544

Sandra M. Gallagher, PhD, Denali Brooke, CMSW, CSAC, Audrey J. Brooks, PhD, and Patricia E. Penn, PhD. La Frontera Center, Inc, 410 S. 6th Ave, Tucson, AZ 85701

Thirteen persons with co-occurring mental illness and substance use disorders (COD), whose records indicated one or more chronic illnesses and/or chronic pain, participated in one of two focus groups. The focus groups were conducted using standard methodology (Morgan, 1988). The purpose was to explore participants’ experiences managing chronic illness and/or pain in addition to COD. Questions covered four areas: interaction of mental illness, substance use, and physical health problems/chronic pain; strategies for managing multiple problems; treatment experiences; and suggestions for improving treatment. Participants were predominantly Caucasian (77%), 50% female, mean age 42 years, and had attained 12.25 years of education. Most were disabled (77%) and 23% indicated being married or having a domestic partner. Most (77%) reported receiving substance abuse treatment. Participants’ reported multiple mental health diagnoses (mean=3.3), health problems (mean=2.5), and pain sites (mean=2.7). Average pain ratings for best (mean=5) and worst (mean=9) days were in the range considered treatable. Nvivo qualitative software was used to structure the data analysis. Barriers (191 comments) include problems with staff, communication, systems (behavioral health and medical), personal, problem complexity, the multidimensional nature of chronic pain, and negative treatment effects. Facilitative conditions (68 comments) include self-awareness (of addiction, mental health, and physical health needs), personal strengths, learning to live with/manage chronic pain, and positive treatment experiences. Finally, the participants offered Suggested solutions (20 comments), such as limiting number of referrals to different providers, centralized and coordinated case management, need for increased resources, and a strong preference for consistently client-centered care.

Learning Objectives:

• Articulate client perspectives on the complex nature of co-occurring substance use, mental health, and physical health disorders.
• Apply new learning in future encounters with persons with co-occurring disorders.
• Discuss methods for addressing needs of persons with co-occurring disorders within health and behavioral health care systems.

Keywords: Co-morbid, Behavioral Research

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.