title: Evaluation of a model for the treatment of combined mental illness and substance abuse: the Bellevue model for peer-led treatment in systems change.
abstract: The present study evaluated a model program at Bellevue Hospital Center incorporating a peer-led self-help (PLSH) approach which can be applied to bring about systems-level change in a variety of settings where persons with dual diagnosis are encountered. A total of 461 consecutive MICA inpatient admissions were evaluated to compare the PLSH unit with two standard psychiatric units. The PLSH program was associated with a higher rate of acceptance of aftercare referral (93% vs. 74%) and aftercare attendance (52% vs. 30%) among patients with no prior psychiatric hospitalizations (N = 111). In addition, the PLSH program appeared to benefit chronically impaired MICA patients (N = 350) or those with a history of prior psychiatric hospitalizations, as they were more likely to accept referral to aftercare treatment than were chronic patients discharged from the standard psychiatric units (96% vs. 81%). Such a program, when more widely applied, could yield decreased recidivism and considerably lower medical, psychiatric, and economic cost.
authors.affiliation: Department of Psychiatry, New York University Medical Center, 550 First Ave, NY, NY 10016, USA.
authors.forename: Helen
authors.initials: H
authors.lastname: Dermatis
authors.forename: Marc
authors.initials: M
authors.lastname: Galanter
authors.forename: Manuel
authors.initials: M
authors.lastname: Trujillo
authors.forename: Claudia
authors.initials: C
authors.lastname: Rahman-Dujarric
authors.forename: Kimberly
authors.initials: K
authors.lastname: Ramaglia
authors.forename: Dorothea
authors.initials: D
authors.lastname: LaGressa
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002908:Chronic Disease; D017831:Diagnosis, Dual (Psychiatry); D005260:Female; D006760:Hospitalization; D006801:Humans; D007902:Length of Stay; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology* / Q000628:therapy*; D008605:Mental Health Services / Q000592:standards*; D008875:Middle Aged; D010343:Patient Admission / Q000706:statistics & numerical data; D010379:Peer Group; D015397:Program Evaluation; D012153:Retention, Psychology; D012657:Self-Help Groups; D019966:Substance-Related Disorders / Q000453:epidemiology* / Q000534:rehabilitation*