Certified Community Behavioral Health Clinic Services for Clients With Co-occurring Disorders: A Latent Class Approach.

IF 3.3 3区 医学 Q1 HEALTH POLICY & SERVICES Psychiatric services Pub Date : 2024-07-10 DOI:10.1176/appi.ps.20230477
Yuanyuan Hu, Ran Hu, Daniel M Baslock, Victoria Stanhope
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Abstract

Objective: Certified community behavioral health clinics (CCBHCs) are designed to provide comprehensive care for individuals with co-occurring mental and substance use disorders. The authors classified outpatient mental health treatment facilities on the basis of provision of services for clients with co-occurring disorders and assessed whether CCBHCs differed from other outpatient mental health facilities in services provided.

Methods: The authors used latent class analysis to identify distinct services for clients with co-occurring disorders in 5,692 outpatient mental health facilities in the 2021 National Substance Use and Mental Health Services Survey. Nine indicators were included: treatment for clients with substance or alcohol use disorder co-occurring with serious mental illness or serious emotional disturbance, specialized programs or groups for such clients, medication-assisted treatment (MAT) for alcohol use disorder, MAT for opioid use disorder, detoxification, individual counseling, group counseling, case management, and 12-step groups. A multinomial logistic regression was used to estimate whether CCBHCs were associated with any identified classes after analyses controlled for facility characteristics.

Results: A four-class solution provided a model with the best fit, comprising comprehensive services (23.4%), case management services (17.7%), counseling and self-help services (58.6%), and professional services (4.3%). Regressing class membership on facility type and covariates, the authors found that compared with community mental health clinics (CMHCs), CCBHCs were more likely to belong to the comprehensive services class than to the case management services, counseling and self-help services, and professional services classes.

Conclusions: CCBHCs were more likely than other outpatient programs to offer comprehensive care, and CCBHC status of a CMHC facilitated enhanced service provisions.

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为共存障碍患者提供的认证社区行为健康诊所服务:潜类法。
目标:经认证的社区行为健康诊所(CCBHCs)旨在为同时患有精神障碍和药物使用障碍的患者提供综合治疗。作者根据为同时患有精神障碍的患者提供服务的情况对门诊精神健康治疗机构进行了分类,并评估了社区行为健康诊所与其他门诊精神健康机构在提供服务方面是否存在差异:作者采用潜类分析法,在2021年全国药物使用和心理健康服务调查中,确定了5692家门诊精神卫生机构为共伴有障碍的患者提供的不同服务。其中包括九项指标:对同时患有严重精神疾病或严重情绪障碍的药物或酒精使用障碍患者的治疗、针对此类患者的专门项目或小组、针对酒精使用障碍的药物辅助治疗(MAT)、针对阿片类药物使用障碍的药物辅助治疗、戒毒、个人咨询、小组咨询、个案管理和 12 步小组。在对设施特征进行分析控制后,采用多项式逻辑回归法估计CCBHC是否与任何已确定的类别相关:四类解决方案提供了一个拟合度最高的模型,包括综合服务(23.4%)、个案管理服务(17.7%)、咨询和自助服务(58.6%)以及专业服务(4.3%)。通过对设施类型和协变量进行分类回归,作者发现,与社区心理健康诊所(CMHC)相比,社区心理健康中心更有可能属于综合服务类,而不属于个案管理服务类、咨询和自助服务类以及专业服务类:结论:与其他门诊项目相比,社区心理健康中心更有可能提供全面的护理服务,而社区心理健康中心的社区心理健康中心身份则有利于提供更多的服务。
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来源期刊
Psychiatric services
Psychiatric services 医学-公共卫生、环境卫生与职业卫生
CiteScore
5.80
自引率
7.90%
发文量
295
审稿时长
3-8 weeks
期刊介绍: Psychiatric Services, established in 1950, is published monthly by the American Psychiatric Association. The peer-reviewed journal features research reports on issues related to the delivery of mental health services, especially for people with serious mental illness in community-based treatment programs. Long known as an interdisciplinary journal, Psychiatric Services recognizes that provision of high-quality care involves collaboration among a variety of professionals, frequently working as a team. Authors of research reports published in the journal include psychiatrists, psychologists, pharmacists, nurses, social workers, drug and alcohol treatment counselors, economists, policy analysts, and professionals in related systems such as criminal justice and welfare systems. In the mental health field, the current focus on patient-centered, recovery-oriented care and on dissemination of evidence-based practices is transforming service delivery systems at all levels. Research published in Psychiatric Services contributes to this transformation.
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