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Substance Abuse Services (substance + abuse_services)
Selected AbstractsThe Impact of Time on Parent Perspectives on the Barriers to Services and the Service Needs of Youths in the Juvenile Justice SystemJUVENILE AND FAMILY COURT JOURNAL, Issue 2 2003GREGORY J. BENNER PH.D. ABSTRACT The purposes of this study were: 1) to assess the overall perspectives of parents (N=115) of youths in the juvenile justice system on the barriers to and services needs of youths in the juvenile justice system; and 2) to assess the strength of the relationship between duration of time the youth has been involved in the juvenile justice system and parent perceptions of barriers and service needs. The top service need was case management. Statistically significant moderate negative correlations were found between duration of time in the juvenile justice system and Total Barrier score, and all composite barrier scores (i.e., Mismatch, Red Tape, and Inaccessibility). Statistically significant small negative correlations were found between duration of time in the juvenile justice system and the Total Service Needs score and two composite scores: Substance Abuse Services and Out-of-Home Services. [source] The Cost-Effectiveness of Independent Housing for the Chronically Mentally Ill: Do Housing and Neighborhood Features Matter?HEALTH SERVICES RESEARCH, Issue 5 2004Joseph Harkness Objective. To determine the effects of housing and neighborhood features on residential instability and the costs of mental health services for individuals with chronic mental illness (CMI). Data Sources. Medicaid and service provider data on the mental health service utilization of 670 individuals with CMI between 1988 and 1993 were combined with primary data on housing attributes and costs, as well as census data on neighborhood characteristics. Study participants were living in independent housing units developed under the Robert Wood Johnson Foundation Program on Chronic Mental Illness in four of nine demonstration cities between 1988 and 1993. Study Design. Participants were assigned on a first-come, first-served basis to housing units as they became available for occupancy after renovation by the housing providers. Multivariate statistical models are used to examine the relationship between features of the residential environment and three outcomes that were measured during the participant's occupancy in a study property: residential instability, community-based service costs, and hospital-based service costs. To assess cost-effectiveness, the mental health care cost savings associated with some residential features are compared with the cost of providing housing with these features. Data Collection/Extraction Methods. Health service utilization data were obtained from Medicaid and from state and local departments of mental health. Non-mental-health services, substance abuse services, and pharmaceuticals were screened out. Principal Findings. Study participants living in newer and properly maintained buildings had lower mental health care costs and residential instability. Buildings with a richer set of amenity features, neighborhoods with no outward signs of physical deterioration, and neighborhoods with newer housing stock were also associated with reduced mental health care costs. Study participants were more residentially stable in buildings with fewer units and where a greater proportion of tenants were other individuals with CMI. Mental health care costs and residential instability tend to be reduced in neighborhoods with many nonresidential land uses and a higher proportion of renters. Mixed-race neighborhoods are associated with reduced probability of mental health hospitalization, but they also are associated with much higher hospitalization costs if hospitalized. The degree of income mixing in the neighborhood has no effect. Conclusions. Several of the key findings are consistent with theoretical expectations that higher-quality housing and neighborhoods lead to better mental health outcomes among individuals with CMI. The mental health care cost savings associated with these favorable features far outweigh the costs of developing and operating properties with them. Support for the hypothesis that "diverse-disorganized" neighborhoods are more accepting of individuals with CMI and, hence, associated with better mental health outcomes, is mixed. [source] Perceptions about services and dropout from a substance abuse case management programJOURNAL OF COMMUNITY PSYCHOLOGY, Issue 5 2007Michael R. Sosin This article uses event history analysis to examine certain determinants of dropout from a case management program that serves homeless adults with substance abuse problems. The examined determinants are perceptions of conventional treatment services: (a) client perceptions concerning the value of the conventional services that case managers help them to obtain, (b) the views of use services held by social contacts, and (c) client perceptions of the legitimacy of conventional services. The findings, some of which involve statistical interactions, suggest that clients drop out of case management services more slowly (a) when they favor pursuit of particularly efficacious conventional programs; (b) when they find conventional programs to be of low legitimacy; (c) when, under special conditions, they perceive that conventional services are less caring; or (d) when social contracts do not pressure them. These findings generally imply that clients look to case management services when they are more skeptical about conventional services. The variables predicting dropout from case management poorly predict continuation in conventional substance abuse services, indicating that dropout is linked to perceptions of services in context-specific ways. © 2007 Wiley Periodicals, Inc. J Comm Psychol 35: 583,602, 2007. [source] Community-Building Before, During, and After Times of Trauma: The Application of the LINC Model of Community Resilience in KosovoAMERICAN JOURNAL OF ORTHOPSYCHIATRY, Issue 1 2010Ferid Agani A family's heritage and values have profound bearing on the stressors they encounter and how they cope. Socioeconomic change, natural and man-made disasters, and international migration are major influences on the integrity of society. In these times of global financial crisis, communities around the world are in danger of losing their intrinsic structure and protective factors. Connectedness or attachment to family and culture of origin correlate with reduced risk-taking behaviors and a reduction in family and societal violence, posttraumatic stress, addiction, depression, suicidality, sexual risk taking, and other chronic and/or life-threatening health problems and illnesses. Facilitating these families' cultural and community ties and enhancing their access to extended-family and community resources can thus be protective against trauma. These relationships foster resilience and reduce the short- and long-term effects of stress on families and communities. Targets of interventions may be individuals, families, or communities. Assessment of vulnerabilities, protective factors, goals, and resources encourages and facilitates collaboration across natural and artificial support systems. Such collaboration is important in building resilience rather than perpetuating vulnerability and long-term problems for individuals, their families, and the communities in which they live. The recent Kosovar experience in implementing the LINC Model of Community Resilience illustrates these principles, as applied in the context of substance abuse services and community rebuilding in the period soon after armed conflict. [source] A Preliminary Report of Knowledge Translation: Lessons From Taking Screening and Brief Intervention Techniques From the Research Setting Into Regional Systems of CareACADEMIC EMERGENCY MEDICINE, Issue 11 2009Edward Bernstein MD Abstract This article describes a limited statewide dissemination of an evidence-based technology, screening, brief intervention, and referral to treatment (SBIRT), and evaluation of the effects on emergency department (ED) systems of care, utilizing the knowledge translation framework of reach, effectiveness, adoption, implementation, and maintenance (RE-AIM), using both quantitative and qualitative data sources. Screening and brief intervention (SBI) can detect high-risk and dependent alcohol and drug use in the medical setting, provide early intervention, facilitate access to specialty treatment when appropriate, and improve quality of care. Several meta-analyses demonstrate its effectiveness in primary care, and the federal government has developed a well-funded campaign to promote physician training and adoption of SBI. In the busy environment of the ED, with its competing priorities, researchers have tested a collaborative approach that relies on peer educators, with substance abuse treatment experience and broad community contact, as physician extenders. The ED-SBIRT model of care reflects clinician staff time constraints and resource limitations and is designed for the high rates of prevalence and increased acuity typical of ED patients. This report tracks services provided during dissemination of the ED-SBIRT extender model to seven EDs across a northeastern state, in urban, suburban, and rural community settings. Twelve health promotion advocates (HPAs) were hired, trained, and integrated into seven ED teams. Over an 18-month start-up period, HPAs screened 15,383 patients; of those, 4,899 were positive for high risk or dependent drinking and/or drug use. Among the positive screens, 4,035 (82%) received a brief intervention, and 57% of all positives were referred to the substance abuse treatment system and other community resources. Standardized, confidential interviews were conducted by two interviewers external to the program with 24 informants, including HPAs and their supervisors, clinicians, nurse managers, and ED directors across five sites. A detailed semistructured format was followed, and results were coded for thematic material. Barriers, challenges, and successes are described in the respondents' own words to convey their experience of this demonstration of SBIRT knowledge translation. Five of seven sites were sustained through the second year of the program, despite cutbacks in state funding. The dissemination process provided a number of important lessons for a large rollout. Successful implementation of the ED-SBIRT HPA model depends on 1) external funding for start-up; 2) local ED staff acting as champions to support the HPA role, resolve territorial issues, and promote a cultural shift in the ED treatment of drug and alcohol misuse from "treat and street" to prevention, based on a knowledge of the science of addiction; 3) sustainability planning from the beginning involving administrators, the billing and information technology departments, medical records coders, community service providers, and government agencies; and 4) creation and maintenance of a robust referral network to facilitate patient acceptance and access to substance abuse services. [source] | ||||||||||