Citation

Ford L, Snowden LR, Walser EJ. Eval. Program Plann. 1991; 14(4): 291-298.

Copyright

(Copyright © 1991, Elsevier Publishing)

DOI

10.1016/0149-7189(91)90011-5

PMID

unavailable

Abstract

The present study analyzed differences in utilization patterns and community adjustment between clients in community mental health with and without substance abuse disorders. Of a sample of 144 patients from an outpatient mental health clinic, 37% or 53 subjects were found to have dual disorders; this level of dual diagnosis occurred despite policies excluding dual disorder clients. The dual-diagnosis group had higher missed-appointment rates, spent fewer months in treatment, and had higher dropout rates. The dual-diagnosis group also fared worse in terms of community adjustment: They were more likely to be arrested, hospitalized, or placed on conservatorship during the two-year follow-up period. When multiple regressions were used to assess the relative impact of various factors on utilization and adjustment, dual-diagnosis status was the strongest predictor of subsequent hospitalizations and also was the best indicator, along with affective diagnosis, of missed-appointment rates. Even within community mental health clinics attempting to screen out substance abuse disorders, such disorders are a common occurrence and are associated with problematic patterns of service utilization and community adjustment.