Services to patients with dual diagnoses: findings from Washington's mental health service system.
This study examined how Washington State's (WA) mental health treatment system provided services to patients with substance use disorders or dual diagnoses at several stages of care: crisis commitment, hospitalization, and outpatient treatment. A total of 30 key informants from urban and rural areas were surveyed between February and July 2004 using semi-structured interviews. Key informants represented direct service providers to chief operating officers. Themes, consensus, and disagreements were summarized. Results indicated that best practices are not consistently implemented and administrative and provider barriers hinder provision of more effective care. Findings highlight that work on how to best implement evidence-based practices is critical to improving care of dual diagnosis patients. Limitations of the study are noted as well as future research directions.
Ouimette
Paige
P
Center for Integrated Healthcare, Syracuse VA Medical Center, Syracuse, New York 13210, USA. paigec.ouimette@med.va.gov
Jemelka
Ron
R
Hall
Judy
J
Brimner
Karl
K
Krupski
Antoinette
A
Stark
Kenneth
K
D000328:Adult; D000437:Alcoholism / Q000453:epidemiology* / Q000534:rehabilitation; D015897:Comorbidity; D017831:Diagnosis, Dual (Psychiatry); D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006760:Hospitalization; D006783:Hospitals, State; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology* / Q000534:rehabilitation; D008605:Mental Health Services / Q000600:supply & distribution*; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000534:rehabilitation; D011795:Surveys and Questionnaires; D014861:Washington / Q000453:epidemiology