Treatment for co-occurring mental and substance use disorders in five state Medicaid programs.
- Authors
- Clark, Robin E; Samnaliev, Mihail; McGovern, Mark P
- Year
- 2007
- Journal
- Psychiatric services (Washington, D.C.)
- PMID
- 17602010
- DOI
- 10.1176/ps.2007.58.7.942
OBJECTIVES: This study described the locations and patterns of psychiatric and substance abuse treatment for Medicaid beneficiaries with co-occurring mental and substance use disorders in five states. METHODS: Medicaid beneficiaries aged 21 to 65 with psychiatric or substance use disorders were identified with claims and encounter records. Groups were further divided into those with and those without a diagnosed substance use disorder. Adjusted odds of treatment in community-based settings, inpatient facilities, emergency departments, and hospital outpatient departments were calculated. RESULTS: A total of 92,355 persons had a psychiatric disorder, 34,158 had a substance use disorder, and 14,256 had co-occurring psychiatric and substance use disorders. In all five states, beneficiaries with severe mental illness (schizophrenia, bipolar disorder, or major depression) and a substance use disorder had higher odds of inpatient, emergency department, and hospital-based outpatient psychiatric treatment, compared with those with severe mental illness alone. In four of five states, both severe and less severe mental illness and a co-occurring substance use disorder were associated with lower odds of community-based treatment compared with those with the respective mental illness alone. Compared with those with less severe mental illness alone, individuals with less severe psychiatric disorders and a co-occurring substance use disorder had higher odds of inpatient treatment in all states and of emergency department use in three of five states. Odds of inpatient and outpatient hospital use and emergency department use for substance abuse treatment were higher for persons with severe mental illness and a co-occurring substance use disorder in most states, compared with odds for those with a substance use disorder alone. CONCLUSIONS: Heavy inpatient and emergency department use by Medicaid beneficiaries with co-occurring substance use disorders is a consistent cross-state problem. Co-occurring disorders may decrease the likelihood of community-based treatment for those with less severe mental disorders and for those with severe mental illness, suggesting that policies focusing only on these settings may miss a significant proportion of people with these co-occurring disorders.
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In this knowledge base
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|---|---|---|
| Comorbidity of severe psychotic disorders with measures of substance use. | 2014 | 24382686 |
| Genetics of addictions. | 2010 | 20159342 |
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| A systematic scoping review of interventions to integrate physical and mental healthcare for people with serious mental illness and substance use disorders. | Richardson A et al. | — | 2020 | → |
| Mental Health and Substance Use-Related Hospitalizations Among Women of Reproductive Age in Illinois and Wisconsin. | Bennett AC et al. | — | 2019 | → |
| State variations in Medicaid enrollment and utilization of substance use services: Results from a National Longitudinal Study. | Mojtabai R et al. | — | 2018 | → |
| Comorbidity of severe psychotic disorders with measures of substance use. | Hartz SM et al. | — | 2014 | → |
| Directions for future patient-centered and comparative effectiveness research for people with serious mental illness in a learning mental health care system. | Green CA et al. | — | 2014 | → |
| Randomized controlled trial to evaluate screening and brief intervention for drug-using multiethnic emergency and trauma department patients. | Eisenberg K et al. | — | 2013 | → |
| Validation and comparison of diagnostic accuracy of four screening tools for mental disorders in people seeking treatment for substance use disorders. | Rush B et al. | — | 2013 | → |
| Differential service utilization associated with trauma-informed integrated treatment for women with co-occurring disorders. | Gilbert AR et al. | — | 2012 | → |
| Predicting clinically significant change in an inpatient program for people with severe mental illness. | Gonda T et al. | — | 2012 | → |
| Validation of the co-occurring disorder quadrant model. | McDonell MG et al. | — | 2012 | → |
| Fidelity and outcomes in six integrated dual disorders treatment programs. | Chandler DW | — | 2011 | → |
| Service Utilization Patterns as Predictors of Response to Trauma-Informed Integrated Treatment for Women With Co-occurring Disorders. | Gilbert AR et al. | — | 2011 | → |
| Genetics of addictions. | Hartz SM et al. | — | 2010 | → |
| Genetics of addictions. | Hartz SM et al. | — | 2010 | → |
| Predictors of nonadherence among individuals with bipolar disorder receiving treatment in a community mental health clinic. | Sajatovic M et al. | — | 2009 | → |
| HIV, syphilis, and hepatitis B and C prevalence among patients with mental illness: a review of the literature. | Campos LN et al. | — | 2008 | → |
| Prevalence of co-occurring substance use and other mental disorders in the Canadian population. | Rush B et al. | — | 2008 | → |
| The use of dopamine agonist in the treatment of restless legs syndrome: caution for practitioners and bipolar patients. | Buckner AC | — | 2008 | → |
| Use of health care services by patients with co-occurring severe mental illness and substance use disorders. | Kêdoté MN et al. | — | 2008 | → |
| Co-occurring psychiatric and substance use disorders: a multistate feasibility study of the quadrant model. | McGovern MP et al. | — | 2007 | → |