Comorbid mental health and substance abuse issues among individuals in recovery homes: Prospective environmental mediators.

Individuals with comorbid internalizing psychological symptoms and substance abuse issues often have more negative outcomes and evidence a relative disparity in treatment gains compared to those with only substance abuse issues. The present study examined social mechanisms over time for individuals living in self-governed recovery homes (Oxford Houses) such as 12-step group activities and social support, which likely influence both abstinence and psychological outcomes. Participants (n = 567) from a national United States sample of Oxford Houses completed baseline and multiple follow-up self-report assessments over a one-year period. A structural equation model was utilized to evaluate predicted relationships among baseline symptoms, 12-step activities, social support, and outcome variables. Results indicated that internalizing symptoms were associated with subsequent mutual help activities, but not directly with social support. Living in an Oxford House for six months and number of 12-step meetings attended were partially mediated by social support variables in predicting abstinence outcomes, but not psychological outcomes. Environments such as Oxford Houses may be viable options for recovering individuals with comorbid internalizing psychological problems, although social support mechanisms primarily promote abstinence. Implications for future research and for Oxford House policies are discussed.