Treatment for mental health and substance abuse: Predictors of treatment amount and cost.

다국어 초록 (Multilingual Abstract)

This study examines predictors of treatment amount and treatment cost for patients with mental illness and/or substance abuse disorders. Specifically, the degree to which functional impairment and client demographics predict amount and cost of treatment is examined by treatment modality, as is the contribution of treatment site for clients in both systems.
Alcohol Drug and Mental Health Services in Santa Barbara County provided data for 2343 adult clients, who received treatment services in the mental health and alcohol/drug systems between June 2000 and July 2002. General Linear Modeling examined the effect of each predictor independent of the effects of all other predictors. Analyses of variance and independent samples t&barbelow;-tests examined within and between site differences in amount and cost of treatment for clients serviced at both sites (N = 343).
Results showed that site, rather than patient attributes, made the most significant contribution to amount and cost of services, as well as type of treatment. On average, MH point of entry clients had significantly greater cost of services, tended to have greater number of treatment minutes, but received significantly fewer services than AD point of entry clients. Treatment amount and cost for rehabilitation services were higher in MH while group therapy amount and cost were higher in AD. For clients serviced in both systems, average amount and cost of treatment increased significantly and across all treatment modalities. Also, the MH system delivered costlier treatment, and contrary to the hypothesis, following MH with AD treatment services was costlier than the reverse.
Results also indicated that MH entry-point clients received significantly more services on average in the AD system than clients who remained in the MH system. Clients were also more likely to be referred to an alternate site if they were entered through MH than through AD. Finally, although MH point of entry clients received a lower average number of services in the AD system than AD point of entry clients, no other adjustments were made in either system for comorbid clients.
Findings indicate that the separateness of the MH and AD health care systems characterize treatment for the comorbid.