MONDAY, July 2, 2007 (HealthDay News) -- Medicaid beneficiaries with substance abuse and mental disorders are less likely to use community services, even though most of the medical help for these disorders is community-based, a new study finds.
The study, which is published in the July issue of Psychiatric Services, examined where integrated treatments for co-occurring psychiatric and substance abuse disorders would be most needed for Medicaid recipients.
Psychiatric and substance abuse disorders are a major problem among the Medicaid population, which has 50 percent to 100 percent more cases than the general population.
Previous research has suggested that community-based treatment for these disorders is superior to treatment in hospitals, with the continuity of treatment being weaker and costs being higher in hospital settings. Because of this, care providers have focused on providing intervention programs in community settings, such as clinics and therapists' offices.
Researchers from the University of Massachusetts Medical School and Dartmouth Medical School analyzed whether beneficiaries with co-occurring mental and substance abuse disorders were treated in community-based settings, inpatient facilities, emergency departments or hospital outpatient departments.
The researchers looked at data from more than 126,500 beneficiaries, including almost 18,000 beneficiaries with co-occurring disorders.
They found that the beneficiaries with co-occurring disorders had higher odds of inpatient, emergency room and hospital-based treatment, and lower odds of community-based treatment, compared to beneficiaries with just one disorder.
"Although most intervention policies for co-occurring substance abuse and mental disorders are community-based, a significant number of people with co-occurring disorders never appear in these settings," study co-author Robin E. Clark, director of research at the University of Massachusetts Medical School's Center for Health Policy and Research, said in a prepared statement. "Substance abuse actually lowers the odds of being treated in a community setting," Clark added.
Based on their findings, the authors concluded that to improve mental health and substance abuse treatment for Medicaid beneficiaries, treatments should be provided wherever it will be sought -- in hospital inpatient, emergency department, outpatient and community-based settings.
"We need to provide treatment to people wherever they appear in the treatment system instead of increasing treatment in one setting -- such as the community-based setting -- and hoping they come there," said Clark.
More information
The Substance Abuse and Mental Health Services Administration has more about mental and substance abuse disorders.
