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Combined substance abuse and mental health treatment services and retention among female clients at substance abuse treatment facilities

Olivia Silber Ashley, DrPH1, Jessica Cance, MPH1, Lev S. Sverdlov, MD, PhD2, Sameena Salvucci, PhD2, Alisa Male, MA2, and Thomas M. Brady, PhD3. (1) Center for Interdisciplinary Substance Abuse Research, RTI International, P.O. Box 12194, Research Triangle Park, NC 27709-2194, (919) 541-6427, osilber@rti.org, (2) Synectics for Management Decisions, Inc., 1901 North Moore Street, Suite 900, Arlington, VA 22209, (3) Office of Applied Studies, Substance Abuse and Mental Health Services Administration, Parklawn Building, 5600 Fishers Lane, Suite 16-105, Rockville, MD 20857

Rates of mental health problems are higher among female substance users than male substance users. Research has shown that women in substance abuse treatment are more likely than men in treatment to report problems related to their mental health and are more likely to be diagnosed with both a substance abuse disorder and a mental health disorder. Women with co-occurring substance abuse and psychiatric disorders face unique barriers to substance abuse treatment, such as difficulty in diagnosing and assessing a dual disorder, social stigma attached to both conditions, and insufficient knowledge and training among providers of medical, mental health, and substance abuse treatment services to manage co-existing disorders. For women, remaining in treatment may require not only the availability of specialized treatment services but also resources to address their mental health. Research has identified the benefits of combined substance abuse and mental health treatment for women with co-occurring diagnosis of substance use and mental health disorders, including lowered incidence of continued drug use, increased education and employment, improved parenting and child outcomes, and lowered incidence of repeat pregnancy. However, research has not examined the association between combined substance abuse and mental health treatment and retention among women. This study examines the availability of combined substance abuse and mental health treatment services and correlates of retention in treatment among women. Data for this study were from a nationally representative sample of 1,239 adult female clients’ substance abuse treatment record abstracts collected in Phase II of the Alcohol and Drug Services Study (ADSS). Phase I ADSS data from telephone interviews with facility directors were used to identify the characteristics of the 2,395 facilities corresponding to those clients. Retention was indicated by length of stay in treatment, measured by the number of days between the client’s date of admission and the date of discharge from a substance abuse treatment facility. About 54 percent of substance abuse treatment facilities offered combined substance abuse and mental health treatment services during the year before the survey. Survival analysis indicated that treatment at substance abuse facilities offering combined substance abuse and mental health treatment services was associated with longer stay in treatment among women (HR=0.61; 95% CI=0.47, 0.80; p=0.0005), after controlling for a number of client and facility characteristics. Combined substance abuse and mental health treatment services may improve retention among women, but these services are not available at many facilities.

Learning Objectives:

Keywords: Mental Health, Substance Abuse Treatment

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.

Studies about Health Care Service Utilization by Women (Womens' Health Contributed Papers #2)

The 132nd Annual Meeting (November 6-10, 2004) of APHA