A Brief Treatment Engagement Intervention for Individuals with Co-occurring Mental Illness and Substance Use Disorders: Results of a Randomized Clinical Trial

David A. Smelson, University of Massachusetts Medical School
David Kalman, University of Massachusetts Medical School
Miklos F. Losonczy, New Jersey HealthCare System
Anna Kline, University of Medicine and Dentistry
Usha Sambamoorthi, University of Massachusetts Medical School
Lauren St. Hill, VA New Jersey Healthcare System
Kathy Castles-Fonseca, VA New Jersey Healthcare System
Douglas M. Ziedonis, University of Massachusetts Medical School

Abstract

Study objectives were to evaluate a brief intervention designed to facilitate outpatient engagement following an inpatient psychiatric stay for individuals with mental illness and substance use. A total of 102 veterans were randomly assigned to one of two conditions: (1) Time Limited Care-Coordination (TLC), an eight-week co-occurring disorders intervention or (2) a matched attention (MA) control condition in the form of health education sessions. Both groups also received treatment as usual in inpatient and outpatient settings. Sixty-nine percent of TLC participants attended an outpatient appointment within 14 days of discharge, compared to only 33% of MA participants (P < 0.01). TLC participants were also more likely to be engaged in outpatient services at the end of the intervention period (44 vs. 22%, P < 0.01). This study provided evidence that an eight-week intervention could improve treatment engagement. Research is currently underway to examine impact of TLC intervention beyond the 8 week study period.