@article{ref1,
title="Outpatient mental health and the dual-diagnosis patient: Utilization of services and community adjustment",
journal="Evaluation and program planning",
year="1991",
author="Ford, Lucy and Snowden, Lonnie R. and Walser, Elizabeth J.",
volume="14",
number="4",
pages="291-298",
abstract="The present study analyzed differences in utilization patterns and community adjustment between clients in community mental health with and without substance abuse disorders. Of a sample of 144 patients from an outpatient mental health clinic, 37% or 53 subjects were found to have dual disorders; this level of dual diagnosis occurred despite policies excluding dual disorder clients. The dual-diagnosis group had higher missed-appointment rates, spent fewer months in treatment, and had higher dropout rates. The dual-diagnosis group also fared worse in terms of community adjustment: They were more likely to be arrested, hospitalized, or placed on conservatorship during the two-year follow-up period. When multiple regressions were used to assess the relative impact of various factors on utilization and adjustment, dual-diagnosis status was the strongest predictor of subsequent hospitalizations and also was the best indicator, along with affective diagnosis, of missed-appointment rates. Even within community mental health clinics attempting to screen out substance abuse disorders, such disorders are a common occurrence and are associated with problematic patterns of service utilization and community adjustment.<p />",
language="",
issn="0149-7189",
doi="10.1016/0149-7189(91)90011-5",
url="http://dx.doi.org/10.1016/0149-7189(91)90011-5"
}