Abstract
The current study describes a system-wide method of evaluating detection strategies for co-occurring disorders within a state mental health system. Information technology was used to merge administrative datasets from the New Jersey mental health and substance abuse systems and identify individuals treated in both systems. We measured a 53% detection rate of substance use disorders amongst adult patients in the mental health system with particularly low detection rates in acute settings (49.0%) and among female (43.7%), older (36.2%), and psychotic patients (43.6%). The methodology described here could help evaluate critical aspects of ongoing state co-occurring disorder quality improvement initiatives.
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Ananth, J., Vandewater, S., Kamal, M., Brodsky, A., Gamal, R., & Miller, M. (1989). Missed diagnosis of substance abuse in psychiatric patients. Hospital & Community Psychiatry, 40, 297–299.
Awad, I., & Wattis, J. (1990). Alcohol histories in hospital: Does the age and sex of the patient make a difference? British Journal of Addiction, 85, 149–150.
Buchsbaum, D. G., Buchanan, R. G., Poses, R. M., Schnoll, S. H., & Lawton, M. J. (1992). Physician detection of drinking problems in patients attending a general medicine practice. Journal of General Internal Medicine, 7, 517–521.
Clark, R. E., Ricketts, S. K., & McHugo, G. J. (1999). Legal system involvement and costs for persons in treatment for severe mental illness and substance use disorders. Psychiatric Services, 50, 641–647.
Dawson, N. V., Dadheech, G., Speroff, T., Smith, R. L., & Schubert, D. S. (1992). The effect of patient gender on the prevalence and recognition of alcoholism on a general medicine inpatient service. Journal of General Internal Medicine, 7, 38–45.
Drake, R. E., & Mueser, K. T. (2000). Psychosocial approaches to dual diagnosis. Schizophrenia Bulletin, 26, 105–118.
Grant, B. F., Stinson, F. S., Dawson, D. A., Chou, S. P., Dufour, M. C., Compton, W., Pickering, R. P., & Kaplan, K. (2004). Prevalence and co-occurrence of substance use disorders and independent mood and anxiety disorders: Results from the National Epidemiologic Survey on Alcohol and Related Conditions. Archives of General Psychiatry, 61, 807–816.
Green, R. S., & Gracely, E. J. (1987). Selecting a rating scale for evaluating services to the chronically mentally ill. Community Mental Health Journal, 23, 91–102.
Hall, R. C., Popkin, M. K., Devaul, R., & Stickney, S. K. (1977). The effect of unrecognized drug abuse on diagnosis and therapeutic outcome. The American Journal of Drug and Alcohol Abuse, 4, 455–465.
Hoff, R. A., & Rosenheck, R. A. (1998). Long-term patterns of service use and cost among patients with both psychiatric and substance abuse disorders. Medical Care, 36, 835–843.
Hoff, R. A., & Rosenheck, R. A. (1999). The cost of treating substance abuse patients with and without comorbid psychiatric disorders. Psychiatric Services, 50, 1309–1315.
Hu, H. M., Kline, A., Huang, F. Y., & Ziedonis, D. M. (2006). Detection of co-occurring mental illness among adult patients in the New Jersey substance abuse treatment system. American Journal of Public Health, 96, 1785–1793.
Jerrell, J. M., Wilson, J. L., & Hiller, D. C. (2000). Issues and outcomes in integrated treatment programs for dual disorders. The Journal of Behavioral Health Services & Research, 27, 303–313.
Kessler, R. C., Chiu, W. T., Demler, O., Merikangas, K. R., & Walters, E. E. (2005). Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 62, 617–627.
King, R. D., Gaines, L. S., Lambert, E. W., Summerfelt, W. T., & Bickman, L. (2000). The co-occurrence of psychiatric and substance use diagnoses in adolescents in different service systems: Frequency, recognition, cost, and outcomes. The Journal of Behavioral Health Services & Research, 27, 417–430.
Kline, A., Mammo, A., Culleton, R., Crowley, C., & Barton, C. (2002). Treatment access and service utilization by clients in the substance abuse and mental health treatment systems. Trenton, NJ: New Jersey Department of Health and Senior Services.
Laudet, A. B., Magura, S., Vogel, H. S., & Knight, E. (2000). Support, mutual aid and recovery from dual diagnosis. Community Mental Health Journal, 36, 457–476.
Leon, S. C., Lyons, J. S., Christopher, N. J., & Miller, S. I. (1998). Psychiatric hospital outcomes of dual diagnosis patients under managed care. American Journal of Addiction, 7, 81–86.
McInnes, E., & Powell, J. (1994). Drug and alcohol referrals: Are elderly substance abuse diagnoses and referrals being missed? British Medical Journal, 308, 444–446.
McMahon, A. L. (1993). Substance abuse among the elderly. Nurse Practitioner Forum, 4, 231–238.
Minsky, S., Vega, W., Miskimen, T., Gara, M., & Escobar, J. (2003). Diagnostic patterns in Latino, African American, and European American psychiatric patients. Archives of General Psychiatry, 60, 637–644.
Moore, R. D., Bone, L. R., Geller, G., Mamon, J. A., Stokes, E. J., & Levine, D. M. (1989). Prevalence, detection, and treatment of alcoholism in hospitalized patients. The Journal of the American Medical Association, 261, 403–407.
Mueser, K. T., Bellack, A. S., & Blanchard, J. J. (1992). Comorbidity of schizophrenia and substance abuse: Implications for treatment. Journal of Consulting and Clinical Psychology, 60, 845–856.
Pirzada, S. R., Ries, R., & LoGerfo, J. P. (1997). Cost of comorbid alcohol and drug problems. American Journal of Addiction, 6, 193–204.
President’s New Freedom Commission of Mental Health (2003). Achieving the promise: Transforming mental health care in America. Rockville, MD.
Prigerson, H. G., Desai, R. A., & Rosenheck, R. A. (2001). Older adult patients with both psychiatric and substance abuse disorders: Prevalence and health service use. The Psychiatric Quarterly, 72, 1–18.
Smith, D. (2003). The older population in the United States: March 2002. Washington, DC: U.S. Census Bureau, 2003.
Smothers, B. A., Yahr, H. T., & Ruhl, C. E. (2004). Detection of alcohol use disorders in general hospital admissions in the United States. Archives of Internal Medicine, 164, 749–756.
U.S. Department of Health and Human Services. (2002). Report to congress on the prevention and treatment of co-occurring substance abuse disorders and mental disorders. Rockville, MD: Substance Abuse and Mental Health Services Administration.
Wang, P. S., Lane, M., Olfson, M., Pincus, H. A., Wells, K. B., & Kessler, R. C. (2005). Twelve-month use of mental health services in the United States: Results from the National Comorbidity Survey Replication. Archives of General Psychiatry, 62, 629–640.
Woodward, B., Fortgang, J., Sullivan-Trainor, M., Stojanov, H., & Mirin, S. M. (1991). Underdiagnosis of alcohol dependence in psychiatric inpatients. The American Journal of Drug and Alcohol Abuse, 17, 373–388.
Wu, L. T., Kouzis, A. C., & Leaf, P. J. (1999). Influence of comorbid alcohol and psychiatric disorders on utilization of mental health services in the National Comorbidity Survey. American Journal of Psychiatry, 156, 1230–1236.
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This study was supported by a grant from the National Institute of Mental Health: T32 MH16242.
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This paper was presented at the 2005 American Psychiatric Association Annual Meeting (May 21–26, 2005) in Atlanta, Georgia.
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Huang, F.Y., Ziedonis, D.M., Hu, H.M. et al. Using Information Technology to Evaluate the Detection of Co-Occurring Substance Use Disorders Amongst Patients in a State Mental Health System: Implications for Co-Occurring Disorder State Initiatives. Community Ment Health J 44, 11–27 (2008). https://doi.org/10.1007/s10597-007-9102-y
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DOI: https://doi.org/10.1007/s10597-007-9102-y