Elizabeth Evans1, Howard Padwa2, Libo Li2, Veronique Lin2, Yih-Ing Hser2. 1. UCLA Integrated Substance Abuse Programs, Semel Institute for Neuroscience and Human Behavior, 11075 Santa Monica Blvd., Suite 200, Los Angeles, CA 90025, USA. Electronic address: laevans@ucla.edu. 2. UCLA Integrated Substance Abuse Programs, Semel Institute for Neuroscience and Human Behavior, 11075 Santa Monica Blvd., Suite 200, Los Angeles, CA 90025, USA.
Abstract
OBJECTIVE: The aim of this study was to determine mental health service utilization patterns among women treated for substance use disorders (SUD) and identify factors associated with patterns of high mental health service use. METHODS: Data were provided by 4447 women treated for SUD in California during 2000-2002 for whom mental health services utilization records were acquired. A latent class model was fitted to women's high use of services (>6 services/year over 8 years). Multinomial logistic regression was used to identify predisposing, enabling, and need factors associated with utilization patterns. RESULTS: In 8 years after initiating SUD treatment, 50% of women utilized mental health services. High use probability was consistently low for most women (76.9%); for others, however, it decreased immediately following SUD treatment and then increased over time (8.7%), increased immediately following SUD treatment and then decreased (9.3%), or remained consistently high (5.1%). Consistently high services use was negatively associated with marriage (OR 0.60, p<0.05) and employment (OR 0.53, p<0.05) and positively associated with older age (OR 1.04, p<0.001), homelessness (OR 1.68, p<0.05), public assistance (OR 1.76, p<0.01), outpatient SUD treatment (OR 3.69, p<0.01), longer SUD treatment retention (OR 1.00, p<0.01), treatment desire (ORs 1.46, p<0.001), and co-occurring disorder diagnosis (ORs 2.89-44.93, p<0.001). Up to 29% of women with co-occurring mental health disorders at SUD treatment entry did not receive any mental health treatment in the subsequent 8 years. CONCLUSIONS: Mental health services utilization patterns among women treated for SUD are heterogeneous and dynamic. Understanding factors related to women's utilization patterns may aid efforts to optimize care and ensure appropriate use of mental health services.
OBJECTIVE: The aim of this study was to determine mental health service utilization patterns among women treated for substance use disorders (SUD) and identify factors associated with patterns of high mental health service use. METHODS: Data were provided by 4447 women treated for SUD in California during 2000-2002 for whom mental health services utilization records were acquired. A latent class model was fitted to women's high use of services (>6 services/year over 8 years). Multinomial logistic regression was used to identify predisposing, enabling, and need factors associated with utilization patterns. RESULTS: In 8 years after initiating SUD treatment, 50% of women utilized mental health services. High use probability was consistently low for most women (76.9%); for others, however, it decreased immediately following SUD treatment and then increased over time (8.7%), increased immediately following SUD treatment and then decreased (9.3%), or remained consistently high (5.1%). Consistently high services use was negatively associated with marriage (OR 0.60, p<0.05) and employment (OR 0.53, p<0.05) and positively associated with older age (OR 1.04, p<0.001), homelessness (OR 1.68, p<0.05), public assistance (OR 1.76, p<0.01), outpatient SUD treatment (OR 3.69, p<0.01), longer SUD treatment retention (OR 1.00, p<0.01), treatment desire (ORs 1.46, p<0.001), and co-occurring disorder diagnosis (ORs 2.89-44.93, p<0.001). Up to 29% of women with co-occurring mental health disorders at SUD treatment entry did not receive any mental health treatment in the subsequent 8 years. CONCLUSIONS: Mental health services utilization patterns among women treated for SUD are heterogeneous and dynamic. Understanding factors related to women's utilization patterns may aid efforts to optimize care and ensure appropriate use of mental health services.
Keywords:
High use of mental health services; Latent class analysis; Longitudinal study design; Utilization of mental health services; Women with co-occurring mental health and substance use disorders
Authors: Amanda Digel Vandyk; Elizabeth G VanDenKerkhof; Ian D Graham; Margaret B Harrison Journal: Arch Psychiatr Nurs Date: 2014-09-06 Impact factor: 2.218
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