title: Self-reported alcohol and drug use six months after brief intervention: do changes in reported use vary by mental-health status?
abstract: BACKGROUND
  Although brief intervention (BI) for alcohol and other drug problems has been associated with subsequent decreased levels of self-reported substance use, there is little information in the extant literature as to whether individuals with co-occurring hazardous substance use and mental illness would benefit from BI to the same extent as those without mental illness. This is an important question, as mental illness is estimated to co-occur in 37% of individuals with an alcohol use disorder and in more than 50% of individuals with a drug use disorder. The goal of this study was to explore differences in self-reported alcohol and/or drug use in patients with and without mental illness diagnoses six months after receiving BI in a hospital emergency department (ED).
  
  
  METHODS
  This study took advantage of a naturalistic situation where a screening, brief intervention, and referral to treatment (SBIRT) program had been implemented in nine large EDs in the US state of Washington as part of a national SBIRT initiative. A subset of patients who received BI was interviewed six months later about current alcohol and drug use. Linear regression was used to assess whether change in substance use measures differed among patients with a mental illness diagnosis compared with those without. Data were analyzed for both a statewide (n = 828) and single-hospital (n = 536) sample.
  
  
  RESULTS
  No significant differences were found between mentally ill and non-mentally ill subgroups in either sample with regard to self-reported hazardous substance use at six-month follow-up.
  
  
  CONCLUSIONS
  These results suggest that BI may not have a differing impact based on the presence of a mental illness diagnosis. Given the high prevalence of mental illness among individuals with alcohol and other drug problems, this finding may have important public health implications.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Center for Healthcare Improvement for Addictions, Mental Illness and Medically Vulnerable Populations (CHAMMP), University of Washington at Harborview Medical Center, Seattle, WA, USA. krupski@u.washington.edu
authors.forename: Antoinette
authors.initials: A
authors.lastname: Krupski
authors.forename: Jeanne M
authors.initials: JM
authors.lastname: Sears
authors.forename: Jutta M
authors.initials: JM
authors.lastname: Joesch
authors.forename: Sharon
authors.initials: S
authors.lastname: Estee
authors.forename: Lijian
authors.initials: L
authors.lastname: He
authors.forename: Alice
authors.initials: A
authors.lastname: Huber
authors.forename: Chris
authors.initials: C
authors.lastname: Dunn
authors.forename: Peter
authors.initials: P
authors.lastname: Roy-Byrne
authors.forename: Richard
authors.initials: R
authors.lastname: Ries
mesh_terms: D000328:Adult; D000368:Aged; D019973:Alcohol-Related Disorders / Q000453:epidemiology / Q000628:therapy; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016014:Linear Models; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology* / Q000628:therapy*; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D011614:Psychotherapy, Brief / Q000379:methods*; D019966:Substance-Related Disorders / Q000453:epidemiology* / Q000628:therapy*; D016896:Treatment Outcome; D055815:Young Adult