Saving Lives of Individuals With Co-Occurring Disorders

Posted on: October 10, 2016

News & Insights from Santa Monica Psychiatrist Katherine Watkins, M.D.

The data are stark. Mental and substance use disorders are leading causes of preventable deaths. This fact is especially significant for institutions within the health case system. These institutions do not have much influence over some causes of premature mortality, such as accidents and homicides, but they can control the quality of care they deliver, which may indeed have a significant effect on decreasing premature mortality.

Highlights

• The first study to validate quality measures for co-occurring disorders.
• Four out of five quality measures are associated with decreased mortality.
• Findings are unlikely to be the result of unmeasured confounders.
• Increasing the number of visits of any modality is likely to decrease mortality.

With these premises in mind, our team set out to conduct research on the subject and published our findings in the Journal of Substance Abuse Treatment in an article: “Association Between Quality Measures and Mortality in Individuals With Co-Occurring Mental Health and Substance Use Disorders.”

Our objective focused on examining the association between five quality measures and 12- and 24-month mortality. The participants in our study all received care paid for by the Veterans Administration between October 2006 and September 2007. The quality measures included included receipt of psychosocial treatment, receipt of psychotherapy, treatment initiation and engagement, and a measure of continuity of care.

The results of our study were striking. All measures except for treatment engagement at 24 months were significantly associated with lower mortality at both 12 and 24 months. At 12 months, receiving any psychosocial treatment was associated with a 21% decrease in mortality; psychotherapy, a 22% decrease; treatment initiation, a 15% decrease, treatment engagement, a 31% decrease; and quarterly, diagnosis-related visits a 28% decrease.

The conclusion that can be drawn from these results is equally encouraging: By devising strategies to improve performance on these measures, health care systems may be able to decrease the mortality of this vulnerable population. And that is very good news indeed.

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Posted in: Co-Occurring Disorders