Differences in self and independent ratings on an organisational dual diagnosis capacity measure
ABSTRACT There are a number of tools to assist services to measure their capacity to respond to co-occurring substance use and mental health disorders. This study aimed to examine whether services could accurately self-rate their dual diagnosis capacity.
Data were collected from 13 alcohol and drug services across Australia that participated in a comorbidity capacity building initiative. The organisations provided a range of services, including pharmacotherapy and counselling services, residential and outpatient services, youth and adult services and withdrawal. There was a mix of government and non-government services.
Services rated themselves substantially higher than the independent raters at both baseline and follow up.
The results suggest that services may not accurately assess their own capacity. For organisations trying to make improvements in their services, independent assessment may be more helpful than self-assessment in accurately determining service gaps. Overestimation of capacity may lead to failure to address important service needs.
Full-textDOI: · Available from: Nicole Kathleen Lee, May 29, 2015
SourceAvailable from: Erick Guerrero[Show abstract] [Hide abstract]
ABSTRACT: We evaluated program capacity factors associated with client outcomes in publicly funded substance abuse treatment organizations in one of the most populous and diverse regions of the United States. Using multilevel cross-sectional analyses of program data (n = 97) merged with client data from 2010 to 2011 for adults (n = 8,599), we examined the relationships between program capacity (leadership, readiness for change, and Medi-Cal payment acceptance) and client wait time and treatment duration. Acceptance of Medi-Cal was associated with shorter wait times, whereas organizational readiness for change was positively related to treatment duration. Staff attributes were negatively related to treatment duration. Overall, compared to low program capacity, high program capacity was negatively associated with wait time and positively related to treatment duration. In conclusion, program capacity, an organizational indicator of performance, plays a significant role in access to and duration of treatment. Implications for health care reform implementation in relation to expansion of public health insurance and capacity building to promote health equities are discussed.Administration and Policy in Mental Health and Mental Health Services Research 12/2014; DOI:10.1007/s10488-014-0617-6 · 3.44 Impact Factor
[Show abstract] [Hide abstract]
ABSTRACT: This study assessed gains that New York State mental health and addiction outpatient clinics achieved in their capacity to provide integrated mental health and substance abuse services for persons with co-occurring disorders. The investigators used two Dual Diagnosis Capability (DDC) indices-one for Addiction Treatment (DDCAT) and one for Mental Health Treatment (DDCMHT)-to measure integration capability at baseline (n = 603) and at follow-up (n = 150), an average of 2 years post-baseline, during which time programs received technical assistance and implementation support. At baseline, the average program score was 2.68, below the "Capable" level (3.0 on a 5-point scale). At follow-up, the average score was 3.04, and the percent of programs rated Capable more than doubled (from 22 to 52%). Programs with lower baseline scores and those with more time to follow-up (2-3 years) had the greatest increases, but 12 to 18 months were sufficient to realize sizeable and significant improvements.The Journal of Behavioral Health Services & Research 06/2014; DOI:10.1007/s11414-014-9419-6 · 1.03 Impact Factor
[Show abstract] [Hide abstract]
ABSTRACT: In the advent of health care reform, models are sought to integrate behavioral health and routine medical care services. Historically, the behavioral health specialty has not itself been integrated, but instead bifurcated by substance use and mental health across treatment systems, care providers and even research. With the present opportunity to transform the health care delivery system, it is incumbent upon policymakers, researchers and clinicians to avoid repeating this historical error, and provide integrated behavioral health services in medical contexts. An organizational measure designed to assess this capacity is described: the Dual Diagnosis Capability in Health Care Settings (DDCHCS). The DDCHCS was used to assess a sample of federally-qualified health centers (N = 13) on the degree of behavioral health integration. The measure was found to be feasible and sensitive to detecting variation in integrated behavioral health services capacity. Three of the 13 agencies were dual diagnosis capable, with significant variation in DDCHCS dimensions measuring staffing, treatment practices and program milieu. In general, mental health services were more integrated than substance use. Future research should consider a revised version of the measure, a larger and more representative sample, and linking organizational capacity with patient outcomes.Journal of Substance Abuse Treatment 12/2012; 43(4):402-409. DOI:10.1016/j.jsat.2012.08.013 · 3.14 Impact Factor