title: Utilizing peer mentorship to engage high recidivism substance-abusing patients in treatment.
abstract: BACKGROUND
  Often high recidivism substance-using patients have difficulty connecting to outpatient treatment contributing to greater functioning disturbances. Approaches to address this problem frequently are staff extensive.
  
  
  OBJECTIVE
  This study evaluates the impact of peer mentorship and/or enhanced dual recovery treatment (DRT) on individuals who are inpatients, substance abusing, and have a history of high recidivism. The primary outcome is post-discharge treatment attendance.
  
  
  METHODS
  In an inpatient Veterans Administration hospital setting, 96 patients with a history of high recidivism and current and/or past diagnosis of substance use disorders were randomized to either (i) Treatment As Usual (TAU), (ii) TAU + DRT + Mentorship for Addictions Problems to Enhance Engagement to Treatment (MAP-Engage), or (iii) TAU + MAP-Engage.
  
  
  RESULTS
  Overall MAP-Engage was found to be comparable to the DRT + MAP-Engage and both of these conditions were significantly better than TAU alone at increasing adherence to post-discharge substance abuse, medical, and mental health outpatient appointments. CONCLUSION/SCIENTIFIC SIGNIFICANCE: MAP-Engage offers an alternative approach to address lack of attendance to outpatient treatment appointments post discharge that is relatively low in staff reliance.
authors.affiliation: Community Research and Recovery Program, Department of Psychiatry, New York University School of Medicine, New York, NY 10010, USA. kathleen.tracy@nyumc.org
authors.forename: Kathlene
authors.initials: K
authors.lastname: Tracy
authors.forename: Mark
authors.initials: M
authors.lastname: Burton
authors.forename: Charla
authors.initials: C
authors.lastname: Nich
authors.forename: Bruce
authors.initials: B
authors.lastname: Rounsaville
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care / Q000458:organization & administration; D017831:Diagnosis, Dual (Psychiatry); D005260:Female; D006787:Hospitals, Veterans; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000150:complications; D008611:Mentors; D008875:Middle Aged; D009519:New York City; D010379:Peer Group; D011446:Prospective Studies; D012008:Recurrence; D016320:Substance Abuse Treatment Centers / Q000458:organization & administration*; D019966:Substance-Related Disorders / Q000150:complications / Q000534:rehabilitation*