{"title":"The Fort Bragg Demonstration Project: a look back.","authors":"M L Paris","doi":"10.1007/BF02518649","DOIUrl":"https://doi.org/10.1007/BF02518649","url":null,"abstract":"","PeriodicalId":73827,"journal":{"name":"Journal of mental health administration","volume":"23 1","pages":"122-4"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/BF02518649","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21025825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Toward cost-effective care for persons with dual diagnoses.","authors":"J M Jerrell","doi":"10.1007/BF02522306","DOIUrl":"https://doi.org/10.1007/BF02522306","url":null,"abstract":"<p><p>Implementing services that control costs and improve client functioning for persons with both severe psychiatric and substance disorders is paramount in a managed care environment. In this clinical trial, standard mental health care augmented by the behavioral skills intervention was more effective than two other approaches (case management and modified 12-step recovery) in interventions with persons with dual diagnoses across indicators of psychosocial adjustment, psychiatric and substance abuse symptoms, and mental health service costs. These findings reinforce the need to address mental health and substance disorders concomitantly; to provide skill-building interventions as the primary ingredient of active treatment to address various instrumental, coping, and social skill deficits that clients with dual diagnoses have; and to monitor the effectiveness of the services and client progress every six months on multiple adjustment and symptomatology dimensions.</p>","PeriodicalId":73827,"journal":{"name":"Journal of mental health administration","volume":"23 3","pages":"329-37"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/BF02522306","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21044182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Methodological advances in the use of recidivism rates to assess mental health treatment programs.","authors":"T L Hafemeister, S M Banks","doi":"10.1007/BF02519110","DOIUrl":"https://doi.org/10.1007/BF02519110","url":null,"abstract":"<p><p>This study of recidivism rates within a state psychiatric system identifies and controls for a number of flaws in other recidivism studies and provides one of the few direct comparisons between different mental health programs using recidivism rates as a dependent variable. It is not an attempt to predict the likelihood of an individual patient's recidivism or to improve the treatment provided the individual patient. Instead, it is an endeavor to address the issue of using recidivism rates to assess a treatment program's effectiveness and to examine such treatment at the macro- or system wide level.</p>","PeriodicalId":73827,"journal":{"name":"Journal of mental health administration","volume":"23 2","pages":"190-206"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/BF02519110","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21028826","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
D A Luke, C T Mowbray, K Klump, S E Herman, B BootsMiller
{"title":"Exploring the diversity of dual diagnosis: utility of cluster analysis for program planning.","authors":"D A Luke, C T Mowbray, K Klump, S E Herman, B BootsMiller","doi":"10.1007/BF02522304","DOIUrl":"https://doi.org/10.1007/BF02522304","url":null,"abstract":"<p><p>This study demonstrates the utility of using cluster analysis to explore the heterogeneity of dual diagnosis populations so as to facilitate planning and implementation of individualized treatment programs. A sample of 467 persons admitted to a state psychiatric hospital with DSM-III-R psychiatric diagnoses and substance abuse problems were interviewed on the Addiction Severity Index (ASI) and other measures to assess psychological, social, and community functioning. Scores on seven ASI severity ratings (medical, employment, alcohol, drug, legal, family, and psychiatric functioning) were used to group patients into seven homogeneous subgroups using cluster analysis: best functioning, unhealthy alcohol abuse, functioning alcohol abuse, drug abuse, functioning polyabuse, criminal polyabuse, and unhealthy polyabuse. Cluster reliability and validity were demonstrated using split-half tests as well as cross-sectional and longitudinal analyses. Results illustrate the extreme heterogeneity of dual diagnosis and are suggestive of how individualized treatment programs can be matched to the particular needs of patients with dual diagnoses.</p>","PeriodicalId":73827,"journal":{"name":"Journal of mental health administration","volume":"23 3","pages":"298-316"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/BF02522304","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21044245","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Day versus inpatient treatment for cocaine dependence: an experimental comparison.","authors":"R Schneider, C Mittelmeier, D Gadish","doi":"10.1007/BF02519114","DOIUrl":"https://doi.org/10.1007/BF02519114","url":null,"abstract":"<p><p>This study was designed to explore the question of whether day treatment is a viable alternative to inpatient treatment for cocaine-dependent patients. Inpatient subjects were compared with day treatment subjects in a randomized, prospective study design. Treatment outcome was evaluated at three and six months posttreatment. At three months posttreatment, the inpatient group had a statistically significant higher rate of total abstinence than the day-treatment group, but the difference at six months was not statistically significant. The two groups also were statistically comparable at six months posttreatment in terms of ¿current¿ abstinence and in terms of other measures. Average costs for day-treatment subjects was 48-61% of the cost for inpatient subjects. The results of this study support the use of day treatment as a clinically and economically effective alternative to inpatient treatment for many cocaine-dependent patients, especially when steps are taken to minimize drop out.</p>","PeriodicalId":73827,"journal":{"name":"Journal of mental health administration","volume":"23 2","pages":"234-45"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/BF02519114","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21044958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The evaluation of the Fort Bragg Demonstration Project: an alternative interpretation of the findings.","authors":"R M Friedman, B J Burns","doi":"10.1007/BF02518651","DOIUrl":"https://doi.org/10.1007/BF02518651","url":null,"abstract":"","PeriodicalId":73827,"journal":{"name":"Journal of mental health administration","volume":"23 1","pages":"128-36"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/BF02518651","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21025829","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Parents' perspectives on quality in family support programs.","authors":"S E Herman, M O Marcenko, K L Hazel","doi":"10.1007/BF02519107","DOIUrl":"https://doi.org/10.1007/BF02519107","url":null,"abstract":"<p><p>Support services for families who have a member with developmental disabilities are a growing component of many state mental health systems. Family empowerment is a key principle of these programs, but parents and the staff who work with them are often challenged in their efforts to have parents participate in policy development, program management, and evaluation of programs. The use of nominal group techniques is described as a means of identifying factors parents believe characterize quality family support programs. Parents' identified factors are then compared with factors from a theoretical framework for quality. Parents stressed access to information, adherence to empowerment philosophy, and the importance of interpersonal relationships with staff. Parents placed less emphasis on factors generally found in accreditation criteria.</p>","PeriodicalId":73827,"journal":{"name":"Journal of mental health administration","volume":"23 2","pages":"156-69"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/BF02519107","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21028962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
L C Jordan, D A Luke, C T Mowbray, S E Herman, W S Davidson, C Conklin
{"title":"Correlates of functioning in a population with dual diagnoses: an examination of diagnosis and problem history.","authors":"L C Jordan, D A Luke, C T Mowbray, S E Herman, W S Davidson, C Conklin","doi":"10.1007/BF02522301","DOIUrl":"https://doi.org/10.1007/BF02522301","url":null,"abstract":"<p><p>This study examines the relationship between diagnosis and life functioning using the Addiction Severity Index (ASI) with 467 hospitalized individuals with mental illness and substance abuse problems. Persons diagnosed with schizophrenia were the best functioning group across most of the ASI domains except employment and psychiatric functioning. More robust relationships were found between problem history (i.e., prior symptomatology or treatment) and current functioning. Respondents with histories of drug treatment, prior experience of anxiety and depression, self-injurious behavior, or violence control problems experienced more severe medical, drug, alcohol, psychiatric, legal, and family/social problems at the time of hospitalization. Violence control problems were related to drug use and criminal involvement, whereas self-injurious behavior was more often related to alcohol use and psychiatric distress. These findings suggest that problem history may be a stronger predictor of treatment need at the time of hospital entry than are more commonly used indexes, such as diagnosis.</p>","PeriodicalId":73827,"journal":{"name":"Journal of mental health administration","volume":"23 3","pages":"260-71"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/BF02522301","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21044240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Needs assessment of community-based services for children and youth with emotional or behavioral disorders and their families: Part 1. A conceptual model.","authors":"M H Epstein, K Quinn, C Cumblad, D Holderness","doi":"10.1007/BF02521026","DOIUrl":"https://doi.org/10.1007/BF02521026","url":null,"abstract":"<p><p>Communities throughout the nation are attempting to develop comprehensive systems of community-based, interagency care for children and youth with emotional or behavioral disorders and their families. Needs assessment has been identified as a key component of these initiatives. A needs assessment provides system planners with the data needed to make informed decisions with regard to improving the current system of care. In this first of a two-article series, an overview is presented of a model needs assessment designed for implementation by an interagency coalition interested in developing a comprehensive system of community-based services for children and youth with emotional or behavioral disorders and their families. Major components of the model include foundations for needs assessment, data collection, and data utilization.</p>","PeriodicalId":73827,"journal":{"name":"Journal of mental health administration","volume":"23 4","pages":"418-31"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/BF02521026","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19927595","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Reported comorbidity of mental disorders with substance abuse among psychiatric inpatients in Israel.","authors":"J Rabinowitz, M Mark, M Popper, M Slyuzberg","doi":"10.1007/BF02521030","DOIUrl":"https://doi.org/10.1007/BF02521030","url":null,"abstract":"<p><p>In preparation for shifting of care from psychiatric hospital to the community, the prevalence of substance abuse comorbidity among discharged psychiatric patients was studied. Such patients are not usually treated by substance abuse programs or mental health clinics. Data from the Israeli National Psychiatric Case Registry were analyzed on reported substance abuse among all 53,379 psychiatric discharges during 1989-92. The Registry consists of data that physicians are mandated to report on all patients. The authors found that reported substance abuse comorbidity was 13.2% for males and 3.6% for females. Patients with a diagnosis of personality disorder had the most reported substance abuse. Reported drug abuse for males increased with age until age 45, and alcohol abuse until age 65. Drug and alcohol abuse by females is the highest for the patients under age 24 and declines with an increase in age. The results were almost identical for each of the four years studied. The results suggest that developing special outpatient facilities to serve this group will be impractical because of the small numbers. Ways of serving these patients in existing community mental health centers are discussed.</p>","PeriodicalId":73827,"journal":{"name":"Journal of mental health administration","volume":"23 4","pages":"471-8"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/BF02521030","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19927599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}