Treatment outcome of an outpatient treatment program for dually-diagnosed veterans: The Cincinnati Veterans Affairs Medical Center

The Dual Diagnosis Clinic at the Cincinnati VA Medical Center is an integra ted treatment program for veterans who have an Axis I psychiatric illness i n addition to a substance dependence problem. With a high staff-to-patient ratio and an individualized approach, the DDC treats many dual diagnosis pa tients effectively. To demonstrate the effectiveness of this approach, an o utcome study was conducted looking at the psychiatric emergency room visits , hospitalization rates, and the average length of stay for 557 DDC patient s. Patients were divided into two groups: those who completed the assessmen t period, and those who did not. Equal periods of time before and after thi s assessment period were studied. Those who completed were more likely to h ave had fewer psychiatric emergency room visits (p<0.000001) after the asse ssment period than before when compared to dropouts. The engaged group had the same or more hospital admissions after the assessment period than befor e, while the dropout group had fewer. This suggests that there is a signifi cant disorder of engagement for the dual diagnosis populations, and that th e first impact of successful treatment is engagement.