Browsing by keyword "Dual diagnosis"

Now showing items 1-3 of 3

    • Implementation of MISSION-Criminal Justice in a Treatment Court: Preliminary Outcomes Among Individuals With Co-occurring Disorders
      Pinals, Debra A.; Gaba, Ayorkor; Clary, Kelsey M.; Barber, John; Reiss, Juliana; Smelson, David A. (2019-07-24)
      OBJECTIVE: Mental health courts provide an alternative to incarceration and address both mental health and criminal justice needs. Many individuals within these treatment courts also have co-occurring substance use disorders. This pilot study examined the preliminary effectiveness of Maintaining Independence and Sobriety through Systems Integration, Outreach, and Networking-Criminal Justice (MISSION-CJ), an intervention that targets co-occurring disorders and criminal justice risk factors within a mental health court. METHODS: Participants (N=97) were enrolled in mental health court and MISSION-CJ community wraparound services. RESULTS: Participants were primarily male with an average age of 34, had spent an average of more than 5 years incarcerated, and had an average of 13.94 years of illegal drug use; 91% had experienced depression. Preliminary 6-month outcomes showed significant reduction in nights incarcerated (p < 0.002), illegal drug use (p < 0.003), trauma symptoms (p < 0.004), and behavioral health symptoms (p < 0.006). CONCLUSIONS: Preliminary findings suggest promise for delivery of MISSION-CJ to participants in a mental health court.

    • Preliminary Outcomes from a Community Linkage Intervention for Individuals with Co-Occurring Substance Abuse and Serious Mental Illness
      Smelson, David A.; Losonczy, Miklos F.; Castles-Fonseca, Kathy; Sussner, Bradley D.; Rodrigues, Stephanie; Kaune, Maureen; Ziedonis, Douglas M. (2005-01-01)
      Objective: Few interventions assist individuals with a mental illness and a co-occurring substance abuse disorder in the transition from hospitalization to outpatient treatment. This change in care is often abrupt, resulting in fragmented treatment that jeopardizes recovery. This article reports on the preliminary outcomes from a new eight-week linkage intervention entitled “Time-Limited Case Management (TLC)” that integrates intensive outreach, Dual Recovery Therapy (DRT), and peer support to facilitate outpatient treatment engagement following discharge from Acute Psychiatry. Method: This eight-week naturalistic feasibility study included 59 recently hospitalized subjects with a mental illness and substance abuse disorder who were offered the new service. The individuals who agreed to receive TLC (n = 26) formed the treatment group and those who refused (n = 33) made up the comparison group. Results: The TLC service was successfully implemented into the system and improved the transition from inpatient to outpatient care. The individuals who received the TLC intervention had a higher show rate at the Day Treatment Center intake appointment, attended more days of treatment at the Day Center, had greater pharmacy refill compliance, and were less likely to be lost to follow-up at eight weeks than the comparison group. Conclusion: TLC represents a promising new approach to maintaining continuity in care following psychiatric hospitalization that may be easily implemented in other systems. We are currently in the process of developing an implementation manual and doing a large randomized controlled trial to determine whether the intervention improves substance abuse and psychiatric outcomes in addition to facilitating treatment engagement.

    • Self-Stigma, Self-Esteem, and Co-occurring Disorders
      Rodrigues, Stephanie; Serper, Mark R.; Novak, Sarah; Corrigan, Patrick W.; Hobart, Marie; Ziedonis, Michelle; Smelson, David A. (2013-05-03)
      Objective: The current study sought to examine the relationships among mental health/substance use severity, self-esteem, and components of self-stigma among individuals with co-occurring schizophrenia-spectrum and substance use disorders. Stereotype concurrence, or the internalization of negative preconceptions associated with membership in a stigmatized group, was hypothesized as a mediator. Methods: Forty-nine subjects with co-occurring schizophrenia-spectrum and substance use disorders completed self-stigma, mental health, substance use, and self-esteem assessments. A multiple regression was employed to identify direct effects. Bootstrap mediator analyses were used to identify indirect effects through the hypothesized mediator: stereotype concurrence. Results: Aside from polysubstance dependence (49%), most subjects had a diagnosed co-occurring alcohol use disorder (43%). Dysphoria and alcohol severity were negatively related to self-esteem. Stereotype concurrence mediated the relationship between autistic preoccupation and self-esteem. Conclusions: Self-stigma was related to decreased self-esteem in individuals with a diagnosed co-occurring schizophrenia-spectrum and substance use disorder, which is consistent with previous findings that have linked self-stigma to decreased self-esteem in individuals with either disorder alone. Decreased self-esteem has been linked to treatment noncompliance and relapses, impeding recovery, while improvements in self-esteem have been shown to be an important consequence of stigma reduction. Treatment implications are discussed.