Inpatient substance abuse care and the outcome of subsequent community residential and outpatient care

Aim. To compare participation in treatment and 1-year substance use, sympto m and functioning outcomes between patients with substance use disorders wh o did versus those who did nor have an episode of inpatient care immediatel y prior to an episode of community residential and outpatient mental health care. Design. Two matched groups of 257 patients Each with substance use d isorders were assessed at entry to and discharge from a community residenti al facility (CRF) and at a 1-year follow-up. Findings. Patients in the two treatment groups received a comparable amount of CRF and outpatient, mental health care. Nevertheless, patients who had prior inpatient care were more likely to be employed at 1-year follow-up. In addition, when they entered CRF rare directly, patients with co-morbid psychiatric disorders were more likely to continue use of alcohol and drugs in the CRF and less likely to c omplete the program. These patients also experienced more distress and psyc hiatric symptoms, and were less likely to be employed at the 1-year follow- up. Conclusions. Among patients who seek treatment at Department of Veteran s Affairs (VA) facilities, those who have both substance use and psychiatri c disorders and enter CRF care directly have somewhat worse outcomes than t hose who have an immediately prior episode of inpatient care.