Assessing the Co-occurring Capability of Mental Health Treatment Programs: the Dual Diagnosis Capability in Mental Health Treatment (DDCMHT) Index

  • Heather J. Gotham
  • Jessica L. Brown
  • Joseph E. Comaty
  • Mark P. McGovern
  • Ronald E. Claus
Article

Abstract

The Dual Diagnosis Capability in Mental Health Treatment (DDCMHT) Index was developed to assess the capability of mental health programs to provide substance abuse and co-occurring treatment services. The DDCMHT is an objective scale rated following a site visit that includes semi-structured interviews with staff at all levels, review of program documents and client charts, and ethnographic observation of the milieu and setting. Using data from 67 mental health programs across six states, this study found that the DDCMHT had excellent total score reliability, variable subscale reliability, high inter-rater reliability (n = 18), and moderate construct validity (n = 22). Results also suggest that many mental health programs are at a relatively low level of capability for the delivery of care to individuals with co-occurring disorders. Results from this important new benchmark measure, the DDCMHT, can be used with programs in implementation planning and with treatment systems, states, or national organizations to guide policy change.

Keywords

Co-occurring disorders Fidelity Substance use disorders Implementation 

References

  1. 1.
    Substance Abuse and Mental Health Services Administration, Office of Applied Studies. Results from the 2007 National Survey on Drug Use and Health: National Findings. DHHS Pub. No. (SMA)08-4343. NSDUH Series H-34. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2008.Google Scholar
  2. 2.
    Mueser KT, Noordsy DL, Drake RE, et al. (eds). Integrated Treatment for Dual Disorders: A Guide to Effective Practice. New York: Guilford Press, 2003.Google Scholar
  3. 3.
    Substance Abuse and Mental Health Services Administration. Integrated Treatment for Co-Occurring Disorders Evidence-Based Practices (EBP) Kit. 2003. Retrieved July 13, 2012, from http://store.samhsa.gov/product/SMA08-4367
  4. 4.
    Minkoff K, Cline CA. Changing the world: The design and implementation of comprehensive continuous integrated systems of care for individuals with co-occurring disorders. Psychiatric Clinics of North America 2004; 27:727–743.PubMedCrossRefGoogle Scholar
  5. 5.
    Timko C. Policies and services in residential substance abuse programs: Comparisons with psychiatric programs. Journal of Substance Abuse Treatment 1995; 7:43–59.CrossRefGoogle Scholar
  6. 6.
    Timko C, Dixon K, Moos RH. Treatment for dual diagnosis patients in the psychiatric and substance abuse systems. Mental Health Services Research 2005; 7:229–242.PubMedCrossRefGoogle Scholar
  7. 7.
    Adams AS, Soumerai SB, Lomas J, et al. Evidence of self-report bias in assessing adherence to guidelines. International Journal for Quality in Health Care 1999; 11:187–192.PubMedCrossRefGoogle Scholar
  8. 8.
    McGovern MP, Xie H, Segal SR, et al. Addiction treatment services and co-occurring disorders: prevalence estimates, treatment practices and barriers. Journal of Substance Abuse Treatment 2006; 31:267–275.PubMedCrossRefGoogle Scholar
  9. 9.
    Mee-Lee D, Schulman GD, Fishman M, et al. ASAM Patient Placement Criteria for the Treatment of Substance-Related Disorders (2nd rev). Chevy Chase, MD: American Society of Addiction Medicine, 2001.Google Scholar
  10. 10.
    Lee N, Cameron J. Difference in self and independent ratings on an organisational dual diagnosis capacity measure. Drug and Alcohol Review 2009; 28:682–684.PubMedCrossRefGoogle Scholar
  11. 11.
    McGovern MP, Matzkin AL, Giard JA. Assessing the dual diagnosis capability of addiction treatment services: The Dual Diagnosis Capability in Addiction Treatment (DDCAT) Index. Journal of Dual Diagnosis 2007; 3:111–123.CrossRefGoogle Scholar
  12. 12.
    Gotham HJ, Brown JL, Comaty JE, et al. Dual Diagnosis Capability in Mental Health Treatment (DDCMHT) Index. Retrieved July 13, 2012 from http://ahsr.dartmouth.edu/html/ddcat.html#DDCAT/
  13. 13.
    McGovern MP. Dual Diagnosis Capability in Addiction Treatment (DDCAT) Index. Retrieved July 13, 2012 from http://ahsr.dartmouth.edu/html/ddcat.html#DDCAT/
  14. 14.
    McGovern MP, Becker K, Lambert-Harris C, et al. The Dual Diagnosis Capability in Addiction Treatment (DDCAT) Index: A Six State Collaborative to Enhance Policy and Implement Evidence Based Practices for Persons with Co-Occurring Disorders. Paper presented at the Substance Abuse Policy Research Program Annual Grantee Meeting, Amelia Island, FL, December 6, 2007.Google Scholar
  15. 15.
    Brown J, Comaty J. Statewide Utilization of the DDCAT: Reliability and Feasibility. Paper presented at the Addiction Health Services Research Annual Meeting, Athens, GA, October 17, 2007.Google Scholar
  16. 16.
    Cohen J. Statistical Power Analysis for the Behavioral Sciences, 2nd ed. Hillsdale, NJ: Erlbaum, 1988.Google Scholar
  17. 17.
    Hart LG, Larson E, Lishner GM. Rural definitions for health policy and research. American Journal of Public Health 2005; 95:1149–1155.PubMedCrossRefGoogle Scholar
  18. 18.
    Gotham HJ, Claus RE, Selig K, et al. Increasing program capability to provide treatment for co-occurring substance use and mental disorders: Organizational characteristics. Journal of Substance Abuse Treatment 2010; 38:160–169.PubMedCrossRefGoogle Scholar
  19. 19.
    Substance Abuse and Mental Health Services Administration. Report to Congress on the prevention and treatment of co-occurring substance abuse disorders and mental disorders. DHHS Pub. No. November edition. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2002.Google Scholar

Copyright information

© National Council for Community Behavioral Healthcare 2013

Authors and Affiliations

  • Heather J. Gotham
    • 1
  • Jessica L. Brown
    • 2
  • Joseph E. Comaty
    • 3
  • Mark P. McGovern
    • 4
  • Ronald E. Claus
    • 5
  1. 1.Mid-America Addiction Technology Transfer Center, School of NursingUniversity of Missouri-Kansas CityKansas CityUSA
  2. 2.Division of Policy and Planning, Office of Behavioral HealthLouisiana Department of Health and HospitalsBaton RougeUSA
  3. 3.Baton RougeUSA
  4. 4.Dartmouth Medical SchoolLebanonUSA
  5. 5.WestatRockvilleUSA

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