Abstract

Objectives

The Veterans Affairs (VA) healthcare system is one of the main providers of substance use treatment within the United States, and many veterans with a substance use disorder (SUD) present with co-occurring diagnoses or other concerns. Though there has been increasing recognition of the need for integration of treatments for SUD and comorbid mental illness, there have been limited studies of such programs, particularly within the VA healthcare system. To address that gap in the literature, this paper examines treatment outcomes in an integrated model of dual diagnosis residential treatment for veterans: the Individualized Addictions Consultation Team (I-ACT) program. Methods: The current paper draws from clinical outcome evaluation data within a residential treatment program at a large Midwestern VA Medical Center (VAMC). The I-ACT program provides residential substance abuse treatment to individuals with a primary SUD and other factors that interfere with the successful completion of a traditional residential rehabilitation program. Between 2017 and 2018, 130 individuals (97.7% men, average age = 60.62 years) entered the I-ACT program. As part of standard measurement-based care, veterans were administered the Brief Addiction Monitor and the Patient Health Questionnaire–9 at admission and discharge. Results: Most individuals (74.6%) who entered I-ACT completed the residential program (average length of stay 34.2 days). Scores on both measures significantly decreased from intake to discharge (p < .001), with the change in depression scores indicating clinically significant improvement. Those with an additional mental health diagnosis achieved similar decreases in substance use symptoms and had lower depression scores at discharge than those with a SUD alone. Conclusions: Our results indicate that even for veterans who may not benefit from traditional SUD treatment programs, a more integrated and personalized residential program can be effective.

中文翻译：

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个性化成瘾咨询团队住院计划：为退伍军人提供综合护理的创造性解决方案，该方案对其他住院治疗计划来说过于复杂

摘要

目标

退伍军人事务部 (VA) 医疗保健系统是美国境内物质使用治疗的主要提供者之一，许多患有物质使用障碍 (SUD) 的退伍军人同时出现诊断或其他问题。尽管人们越来越认识到需要整合 SUD 和共存精神疾病的治疗，但对此类计划的研究有限，尤其是在 VA 医疗保健系统内。为了解决文献中的这一空白，本文研究了退伍军人双重诊断住院治疗的综合模型中的治疗结果：个性化成瘾咨询小组 (I-ACT) 计划。方法：当前论文取材于中西部弗吉尼亚州大型医疗中心 (VAMC) 的住院治疗计划中的临床结果评估数据。I-ACT 计划为患有主要 SUD 和其他干扰传统住宿康复计划成功完成的因素的个人提供住宿药物滥用治疗。2017 年至 2018 年期间，130 人（97.7% 男性，平均年龄 = 60.62 岁）进入了 I-ACT 计划。作为基于测量的标准护理的一部分，退伍军人在入院和出院时接受了简短的成瘾监测器和患者健康问卷 - 9。结果：大多数进入 I-ACT 的人 (74.6%) 完成了住宿计划（平均逗留时间为 34.2 天）。两项措施的得分从摄入到出院都显着下降 ( p < .001)，抑郁症得分的变化表明临床上有显着改善。与单独患有 SUD 的人相比，那些有额外心理健康诊断的人在物质使用症状方面取得了类似的减少，并且出院时的抑郁评分较低。结论：我们的结果表明，即使对于可能无法从传统 SUD 治疗计划中受益的退伍军人，更综合和个性化的住宿计划也可能是有效的。