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Health Services Research & Development

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2005 HSR&D National Meeting Abstract


3092 — A Brief Community Linkage Program for Dually Diagnosed Individuals

Author List:
Smelson dA (VA New Jersey/VISN 3 MIRECC)
Losonczy M (Va New Jersey/VISN 3 MIRECC)
castles-fonseca k (New Jersey/VISN 3 MIRECC)
Sussner B (Robert Wood Johnson medical School)
Stewart p (New Jersey)
Kaune m (New Jersey)
Ziedonis D (Robert Wood Johnson Mediical School)

Objectives:
Individuals with co-occurring mental illness and substance abuse problem have difficulty engaging in outpatient treatments following discharge from Acute Psychiatry. This transitional period often results in relapse and rehospitalization, which is problematic. In an effort to improve outcomes during this vulnerable period, we developed an eight-week community linkage intervention to help transition individuals from Acute Psychiatry and engage them in a MICA outpatient program.

Methods:
Fifty-nine dually diagnosed veterans participated in the research, 26 who received the new Transitional Case Management (TLC) service and 33 who were discharged as usual to MICA.

Results:
The veterans who received the TLC treatment had significantly better attendance at the initial outpatient screening appointment (.02), the follow-up appointment (.001), better overall attendance in the Day Treatment Center (.001), greater pharmacy prescription pick-ups (.11) and were less likely to be lost to follow-up at six weeks (.0001). Furthermore, the six month post treatment outcomes showed that the veterans in the TLC group had a significant reduction in psychiatric rehospitalization days (.05), higher functioning on the Global Assessment in Functioning (.0001) and a greater reduction in symptom severity on all the BASIS 32 subscales (.006, .006, .001 and .002 respectively). Cost-effectiveness data showed that this intervention easily paid for itself, which will be described in the presentation.

Implications:
These outcomes suggest that TLC had robust treatment effects well beyond the eight weeks of treatment.

Impacts:
This brief linkage intervention may assist dually diagnosed veterans in other VA’s and reduce the recidivism common in this population.


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