Original Paper

Administration and Policy in Mental Health and Mental Health Services Research

, Volume 39, Issue 6, pp 426-439

First online:

Differential Service Utilization Associated With Trauma-informed Integrated Treatment for Women With Co-occurring Disorders

  • Allison R. GilbertAffiliated withDepartment of Psychiatry and Behavioral Sciences, Duke University School of Medicine Email author 
  • , Marisa E. DominoAffiliated withDepartment of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill
  • , Joseph P. MorrisseyAffiliated withDepartments of Health Policy and Management and Psychiatry, University of North Carolina at Chapel HillCecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill
  • , Bradley N. GaynesAffiliated withDepartment of Psychiatry, School of Medicine, University of North Carolina at Chapel Hill

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Women with co-occurring mental health and substance use disorders and trauma histories vary greatly in symptom severity and use of support services. This study estimated differential effects of an integrated treatment intervention (IT) across sub-groups of women in this population on services utilization outcomes. Data from a national study were used to cluster participants by symptoms and service utilization, and then estimate the effect of IT versus usual care on 12-month service utilization for each sub-group. The intervention effect varied significantly across groups, in particular indicating relative increases in residential treatment utilization associated with IT among women with predominating trauma and substance abuse symptoms. Understanding how IT influences service utilization for different groups of women in this population with complex needs is an important step toward achieving an optimal balance between need for treatment and service utilization, which can ultimately improve outcomes and conserve resources.


Co-occurring disorders PTSD Integrated treatment Interventions Service utilization