The goal of this 5-year project is to evaluate the comparative effectiveness of the integrated and parallel models for organizing service delivery to dually-diagnosed individuals, within the environmental context of the Los Angeles County treatment systems for mental illness and substance abuse. A total of 400 subjects will be randomly assigned to receive either integrated treatment from outpatient mental health and residential drug treatment programs that jointly deliver dual-diagnosis treatment or concurrent mental health and residential drug treatment delivered by separate programs on a parallel basis. Primary treatment outcomes include retention and completion, service utilization, drug and alcohol use, psychiatric status, criminal behavior, and psychosocial functioning; secondary outcomes include physical health status, HIV risk, and housing status. The study will also identify client characteristics that influence treatment outcomes, either independently or in interaction with different models of service delivery, and examine the influence of program and staff characteristics on client outcomes. The treatment outcome study will be embedded within a study of the environmental context of the mental health and substance abuse treatment systems in Los Angeles County. Interviews will be conducted with county administrators, administrators of programs participating in the treatment outcome study, and administrators of programs that are not in the study for comparison purposes. In addition, surveys will be conducted with staff in these same programs. Focus groups will be conducted with members of key community stakeholder groups and changes in the mental health and substance abuse treatment service systems will be monitored throughout the study. These data will provide a multilevel context in which to evaluate the implementation and effectiveness of the two models of service delivery.

Agency
National Institute of Health (NIH)
Institute
National Institute on Drug Abuse (NIDA)
Type
Research Project (R01)
Project #
5R01DA011966-02
Application #
2898279
Study Section
Special Emphasis Panel (ZDA1-RXC-B (14))
Program Officer
Cartwright, William S
Project Start
1998-08-20
Project End
2003-07-31
Budget Start
1999-08-01
Budget End
2000-07-31
Support Year
2
Fiscal Year
1999
Total Cost
Indirect Cost
Name
University of California Los Angeles
Department
Type
Other Domestic Higher Education
DUNS #
119132785
City
Los Angeles
State
CA
Country
United States
Zip Code
90095
Stein, Judith A; Zane, Jazmin I; Grella, Christine E (2012) Impact of Abstinence Self-Efficacy and Treatment Services on Physical Health-Related Behaviors and Problems among Dually Diagnosed Patients. J Dual Diagn 8:64-73
Grella, Christine E; Shi, Yifei (2011) Stability of Outcomes Following Residential Drug Treatment For Patients with Co-occurring Disorders. J Dual Diagn 7:103-112
Wu, Nancy S; Schairer, Laura C; Dellor, Elinam et al. (2010) Childhood trauma and health outcomes in adults with comorbid substance abuse and mental health disorders. Addict Behav 35:68-71
Gil-Rivas, Virginia; Prause, JoAnn; Grella, Christine E (2009) Substance use after residential treatment among individuals with co-occurring disorders: the role of anxiety/depressive symptoms and trauma exposure. Psychol Addict Behav 23:303-14
Warren, Jazmin I; Stein, Judith A; Grella, Christine E (2007) Role of social support and self-efficacy in treatment outcomes among clients with co-occurring disorders. Drug Alcohol Depend 89:267-74
Grella, Christine E; Stein, Judith A (2006) Impact of program services on treatment outcomes of patients with comorbid mental and substance use disorders. Psychiatr Serv 57:1007-15
Grella, Christine E; Gil-Rivas, Virginia; Cooper, Leslie (2004) Perceptions of mental health and substance abuse program administrators and staff on service delivery to persons with co-occurring substance abuse and mental disorders. J Behav Health Serv Res 31:38-49
Grella, Christine E (2003) Contrasting the views of substance misuse and mental health treatment providers on treating the dually diagnosed. Subst Use Misuse 38:1433-46
Grella, Christine E (2003) Effects of gender and diagnosis on addiction history, treatment utilization, and psychosocial functioning among a dually-diagnosed sample in drug treatment. J Psychoactive Drugs 35 Suppl 1:169-79
Grella, Christine E; Gilmore, James (2002) Improving service delivery to the dually diagnosed in Los Angeles County. J Subst Abuse Treat 23:115-22