Predictors of initiation and engagement in substance abuse treatment among individuals with co-occurring serious mental illness and substance use disorders

Abstract

Research has documented the significant challenges of engaging individuals with comorbid serious mental illness (SMI) and substance use disorders (SUDs) in substance abuse treatment. To date it is unclear which factors predict treatment initiation and engagement in this group of individuals with SUDs. In this study we conducted two analyses using data from a randomized trial of substance abuse treatment in outpatients with SMI: the first examining predictors (collected during screening) of completing an initial intake assessment and the second examining predictors (collected during the intake assessment) of becoming engaged in treatment. Results indicated that males and those with schizophrenia spectrum diagnoses were less likely to complete the intake assessment. Participants who reported more positive feelings about their family were more likely to engage in substance abuse treatment. Participants who were recently arrested were less likely to engage in treatment. Those who met criteria for current drug dependence were less likely to engage in treatment. Overall, these findings are a useful step in determining factors that predict substance abuse treatment initiation and engagement in individuals with SMI and SUDs.

Perceived Barriers to Treatment in a Community-Based Sample of Illicit-Drug-Using African American Men and Women

“…This structural barrier to treatment is in line with previous research in racially diverse samples of drug users (Hser et al 1998). Given that women are reportedly more likely to seek and initiate treatment (Brown et al 2011), findings suggest that institutions look to modify waiting lists or present alternative forms of care when they are unable to attend to the needs of drug users as they apply. This seems imperative, as African Americans are less likely to utilize treatment (Perron et al 2009b) and waiting lists only further current disparities in treatment and care.…”

Reasons for Entering Treatment Reported by Initially Treatment-Resistant Patients with Substance Use Disorders

“…Moreover, the current study's findings that among the top least important reasons for entering treatment were being "forced" to come or legal problems are in line with the results of Marlowe et al (1996) that family interactions are superior to coercion and legal pressure in terms of fostering treatment admission. Recent research confirms that individuals with positive feelings about their family are more likely to enter treatment, and that recently arrested individuals are less likely to engage in treatment (Brown et al, 2011). Overall, a glimpse at the change process in the current study was illustrated through several measures, and although not definitive, the outcome was consistently in line with the CRAFT training offered to the CSOs.…”

“…On the other hand, it is well known that intimate partners, family members, and close friends can alter their own behavior and thereby encourage persons with addiction problems to enter treatment (Copello & Orford, 2002;McCrady, 2004). Also, the finding that positive feelings about family relationships were associated with entering treatment is important in this perspective (Brown, Bennett, Li, & Bellack, 2011). Interestingly, almost 40% of the narrative statements in the current study were considered interpersonal (both positive and negative), which conveys an interaction with family members and demonstrates the inherent power of close relationships to improve life (Copello & Orford, 2002;Hingson, Mangione, Meyers, & Scotch, 1982;Kirby, Marlowe, Festinger, Garvey, & La Monaca, 1999;McCrady, 2004;Miller & Meyers, 2001;Miller et al, 1999;Sisson & Azrin, 1986).…”

Predictors and Moderators of Aftercare Appointment-Keeping Following Brief Motivational Interviewing Among Patients With Psychiatric Disorders or Dual Diagnosis

“…Low adherence among these patients is associated with elevated incidence of poor treatment outcome (Najt, PFusar-Poli, & Brambilla, 2011;Novick et al, 2010;Pantalon & Swanson, 2003;Swanson, Pantalon, & Cohen, 1999) as well as related impairments in daily functioning and elevated risks of violent behavior (Van Dorn, Volavka, & Johnson, 2012) and/or rehospitalization (Brown, Bennett, Li, & Bellack, 2011;Najt et al, 2011).…”