title: Improving the capability to provide integrated mental health and substance abuse services in a state system of outpatient care.
abstract: The paper reports on the capability of New York State (NYS) outpatient programs to provide integrated services for co-occurring disorders (COD). Assessments of 447 outpatient clinics, using two dual diagnosis capability indices (one used in addiction settings, the other in mental health settings), produced an overall score of 2.70, interpreted to position NYS clinics closer to "capable" (3.0 = Dual Diagnosis Capable) than to "basic" (1.0 = Alcohol [Mental Health] Only Services). "Assessment" and "Staffing" received the highest scores; i.e., clients with COD were usually identified, and staff (with some additional training and supervision) could treat both disorders effectively. While programs were generally prepared for clients with COD (e.g., welcoming such clients into the program, employing staff with competencies in both disorders, and having established routine screening and assessment to identify COD), results showed that the actual delivery of effective treatment was less satisfactory. The project demonstrated that COD capability can be assessed system-wide, using direct observation.
authors: Center for the Integration of Research & Practice (CIRP), National Development & Research Institutes, Inc. (NDRI), New York, NY 10010, USA. stansacks@mac.com
authors: Stanley
authors: S
authors: Sacks
authors: Michael
authors: M
authors: Chaple
authors: Jill
authors: J
authors: Sirikantraporn
authors: JoAnn Y
authors: JY
authors: Sacks
authors: James
authors: J
authors: Knickman
authors: Jacqueline
authors: J
authors: Martinez
mesh_terms: D000553:Ambulatory Care / Q000458:organization & administration* / Q000592:standards; D000554:Ambulatory Care Facilities / Q000458:organization & administration; D002983:Clinical Competence; D003695:Delivery of Health Care / Q000458:organization & administration / Q000592:standards; D019033:Delivery of Health Care, Integrated / Q000458:organization & administration*; D017831:Diagnosis, Dual (Psychiatry); D006282:Health Personnel / Q000458:organization & administration / Q000592:standards; D006801:Humans; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D009518:New York; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000534:rehabilitation*