title: A dual diagnosis demonstration project: treatment outcomes and cost analysis.
abstract: This article presents findings from an outpatient dual diagnosis demonstration project that investigated whether integrated treatment services for severely and persistently ill patients with co-occurring mental health and substance abuse disorders could result in improved outcomes and reduction of criminal justice and health care costs. Integrated treatment was defined as a simultaneous focus on both disorders through the provision of psychosocial rehabilitation, psychotherapeutic and psychopharmacologic treatment, and substance abuse recovery and relapse prevention by cross-trained staff. One hundred twenty six (126) patients with multiple DSM-IV Axis I and Axis II disorders were assessed on a variety of mental health, substance abuse, and quality of life measures at baseline and at six-month intervals up to three years post entry into treatment. Criminal justice and health care costs obtained from state and local databases were compared two years before and two years after initiation of treatment to determine cost differences. The study found statistically significant improvements in psychiatric symptoms, substance abuse, and quality of life outcomes. There were also decreases in criminal justice and acute and sub-acute mental health and alcohol and other drug (AOD) costs and increases in outpatient mental health and physical health care costs.
authors.affiliation: University of California, San Diego School of Medicine, Department of Psychiatry, San Diego, California, USA. pjudd@ucsd.edu
authors.forename: Patricia Hoffman
authors.initials: PH
authors.lastname: Judd
authors.forename: Nancy
authors.initials: N
authors.lastname: Thomas
authors.forename: Terry
authors.initials: T
authors.lastname: Schwartz
authors.forename: Alicia
authors.initials: A
authors.lastname: Outcalt
authors.forename: Richard
authors.initials: R
authors.lastname: Hough
mesh_terms: D003155:Community Mental Health Centers; D015897:Comorbidity; D003365:Costs and Cost Analysis; D003416:Criminal Law / Q000191:economics / Q000706:statistics & numerical data; D003710:Demography; D017831:Diagnosis, Dual (Psychiatry) / Q000191:economics*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005500:Follow-Up Studies; D006801:Humans; D001523:Mental Disorders / Q000191:economics / Q000628:therapy; D008605:Mental Health Services / Q000145:classification / Q000191:economics / Q000706:statistics & numerical data; D017060:Patient Satisfaction; D010555:Personality Inventory; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D016320:Substance Abuse Treatment Centers; D019966:Substance-Related Disorders / Q000191:economics* / Q000628:therapy*; D016896:Treatment Outcome