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Trends in acute mental health care: Comparing psychiatric and substance abuse treatment programs

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Abstract

This study compared psychiatric and substance abuse acute care programs, within both inpatient and residential modalities of care, on organization and staffing, clinical management practices and policies, and services and activities. A total of 412 (95% of those eligible) Department of Veterans Affairs' programs were surveyed nationwide. Some 40% to 50% of patients in psychiatric and substance abuse programs, in both inpatient and residential venues of care, had dual diagnoses. Even though psychiatric programs had a sicker patient population, they provided fewer services, including basic components of integrated programs, than substance abuse programs did. Findings also showed that there is a strong emphasis on the use of clinical practice guidelines, performance monitoring, and obtaining client satisfaction and outcome data in mental health programs. The author's suggest how psychiatric programs might better meet the needs of acutely ill and dually diagnosed patients (eg, by incorporating former patients as role models and mutual help groups, as substance abuse programs do; and by having policies that balance patient choice with program demand).

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Authors and Affiliations

  1. VA Palo Alto Health Care System, Center for Health Care Evaluation, 795 Willow Road (152-MPD), 94025, Menlo Park, CA

    Christine Timko PhD (Research Career Scientist), Michelle Lesar BA (Research Health Science Specialist), Noël J. Calvi EdM (Research Health Science Specialist) & Rudolf H. Moos PhD (Research Career Scientist)

  2. Department of Psychiatry, Stanford University Medical Center, Palo Alto, California

    Christine Timko PhD (Research Career Scientist) & Rudolf H. Moos PhD (Research Career Scientist)

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  1. Christine Timko PhD
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  2. Michelle Lesar BA
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  3. Noël J. Calvi EdM
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  4. Rudolf H. Moos PhD
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Correspondence to Christine Timko PhD.

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Timko, C., Lesar, M., Calvi, N.J. et al. Trends in acute mental health care: Comparing psychiatric and substance abuse treatment programs. The Journal of Behavioral Health Services & Research 30, 145–160 (2003). https://doi.org/10.1007/BF02289804

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