title: Patient satisfaction with treatment for alcohol use disorders: comparing patients with and without severe mental health symptoms.
abstract: BACKGROUND
  Previous studies suggest patients with co-occurring alcohol use disorders (AUDs) and severe mental health symptoms (SMHS) are less satisfied with standard AUD treatment when compared to patients with an AUD alone. This study compared patient satisfaction with standard AUD treatment among patients with and without SMHS and explored how standard treatment might be improved to better address the needs of these patients.
  
  
  METHODS
  Eighty-nine patients receiving treatment for an AUD either at an inpatient hospital, outpatient clinic, inpatient detoxification, or residential/therapeutic community services were surveyed. Patient satisfaction with treatment was assessed using the Treatment Perception Questionnaire (range: 0-40). Patients were stratified according to their score on the Depression Anxiety Stress Scale. Forty patients scored in the extremely severe range of depression (score >14) and/or anxiety (score >10) (indicating SMHS) and 49 patients did not. An inductive content analysis was also conducted on qualitative data relating to areas of service improvement.
  
  
  RESULTS
  Patients with SMHS were found to be equally satisfied with treatment (mean =25.10, standard deviation =8.12) as patients with an AUD alone (mean =25.43, standard deviation =6.91). Analysis revealed that being an inpatient in hospital was associated with reduced treatment satisfaction. Patients with SMHS were found to be significantly less satisfied with staffs' understanding of the type of help they wanted in treatment, when compared to patients with AUDs alone. Five areas for service improvement were identified, including staff qualities, informed care, treatment access and continuity, issues relating to inpatient stay, and addressing patients' mental health needs.
  
  
  CONCLUSIONS
  While findings suggest that AUD treatment services adequately meet the needs of patients with SMHS in treatment, patients with SMHS do feel that staff lack understanding of their treatment needs. Findings have important implications as to how current health care practice might be improved according to the patient's perspective of care.
authors.affiliation: School of Psychology, Faculty of Health Sciences, University of Adelaide.
authors.forename: Stacey L
authors.initials: SL
authors.lastname: McCallum
authors.affiliation: Department of Gastroenterology and Hepatology, Royal Adelaide Hospital; School of Public Health, University of Adelaide.
authors.forename: Jane M
authors.initials: JM
authors.lastname: Andrews
authors.affiliation: School of Public Health, University of Adelaide; Drug and Alcohol Consultation Liaison Service, Royal Adelaide Hospital, Adelaide, SA, Australia.
authors.forename: Matthew D
authors.initials: MD
authors.lastname: Gaughwin
authors.affiliation: School of Psychology, Faculty of Health Sciences, University of Adelaide.
authors.forename: Deborah A
authors.initials: DA
authors.lastname: Turnbull
authors.affiliation: Department of Health Sciences, University of York, Heslington, UK.
authors.forename: Antonina A
authors.initials: AA
authors.lastname: Mikocka-Walus
keywords: MeSH; alcohol use disorder; comorbidity; mental disorder; patient satisfaction; treatment