Influence of Family Involvement and Substance Use on Sustained Utilization of Services for Schizophrenia

Center for Mental Healthcare and Outcomes Research, Central Arkansas Veterans Healthcare System, 2200 Fort Roots Dr., Bldg. 58 (152/NLR), North Little Rock, AR 72114-1706, USA.
Psychiatric services (Washington, D.C.) (Impact Factor: 2.41). 09/2008; 59(8):902-8. DOI: 10.1176/
Source: PubMed


This observational study assessed the influence of family support and substance abuse on patterns of service use by individuals with schizophrenia.
Polychotomous logistic regression was used to analyze an existing database for 258 individuals with schizophrenia who were between the ages of 18 and 67 and were recruited from public mental health care settings. Analyses determined the extent to which two consumer-identified factors, family support and substance abuse status, influenced patterns of outpatient service use (regular, irregular, and infrequent) for schizophrenia.
After the analysis adjusted for insight into illness, cognitive functioning, rural or urban residence, and gender, comorbid substance abuse and the interaction between substance abuse status and family support were significantly associated with patterns of service use. Comorbid substance abuse predicted irregular or infrequent patterns of service use over time. Stratified analyses indicated that weekly family support substantially reduced the adverse impact of substance abuse status on consumers' patterns of service use, especially for those living in rural areas.
This study provides evidence that ongoing family support is associated with substantial reductions in the adverse impact of substance abuse on consumers' patterns of service use, especially for consumers living in rural areas. If confirmed in other populations, study findings suggest that reinforcing services and support for family members who provide informal care helps to sustain involvement in care by the especially vulnerable population of individuals with a dual diagnosis of schizophrenia and substance abuse.

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Available from: Richard R Owen, Sep 08, 2015
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    • "Positive feelings about time spent and interactions with family members was related to greater odds of engaging in treatment. These findings are in line with a range of research that highlights the benefits of family relationships in terms of getting people into treatment both in primary substance abusers (Copello, Templeton, & Velleman, 2006) and among those with SMI (see Dixon et al, 2009 for a review; Fischer et al., 2008; Harvery, Jefferys, McNaught, Blizard, & King, 2007; Mueser et al., 2009) and first-episode psychosis (Compton, Goulding, Gordon, Weiss, & Kaslow, 2009). Often individuals seek substance abuse treatment specifically at the request of relatives or because of the damage their substance use is doing to relationships with family members. "
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    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.
    Full-text · Article · Dec 2010 · Addictive behaviors
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