Skip to main content

Table 3 Outcomes for studies on integrated delivery of mental health and substance abuse services

From: Integration of priority population, health and nutrition interventions into health systems: systematic review

Type of outcome

Study

Measure

Outcome (Intervention vs. Control)

Health outcomes

Druss 2001

Change in physical component summary index.

+4.7% vs. -0.3%, (p < 0.001)

  

Change in mental component summary index.

+2.4% vs. +2%, (p = 0.84)

 

Krahn 2006

Change in Centre for Epidemiological Studies Depression scale (CES-D) score.

Patients with all depression:

-6.0 ± 12.0 vs. -7.8 ± 11.8, (p = 0.07)

   

Patients with major depression:

-7.5 ± 13.1 vs. -10.2 ± 12.1, (p = 0.003)

  

Change in Medical Component Score (MCS).

Patients with all depression:

+4.8 ± 12.6 vs. +4.9 ± 12.9, (p = 0.88)

   

Patients with major depression:

+5.9 ± 12.6 vs. + 6.8 ± 12.8, (p = 0.32)

 

Willenbring 1999

Number of patients with 2-year survival.

31/38 (81%) vs. 26/37 (70%), (p = 0.03)

Drug and alcohol use

Oslin 2006

Change in number of drinks per week.

-6.0 vs. -5.9 (p = 0.913)

  

Change in number of binge episodes in the preceding three months.

-8.5 vs. -10.2 (p = 0.750)

 

Weisner 2001

Total abstinence and duration of abstinence.

Non-SAMC patients:

66% vs. 73%, (p = 0.23)

   

SAMC patients:

69% vs. 55%, (p = 0.006); period of abstinence 135 days vs. 122 days, (p = 0.05)

  

Alcohol abstinence.

Non-SAMC patients:

73% vs. 78% (p = 0.41)

   

SAMC patients:

80% vs. 65%, (p = 0.002)

  

Other drug abstinence

Non-SAMC patients:

84% vs. 87%, (p = 0.50)

 

Willenbring 1999

Number of patients with alcohol abstinence after 2 years.

28/38 (74%) vs. 17/36 (48%), (p = 0.02)

Patient satisfaction

Druss 2001

Satisfaction score on 47-item questionnaire.

Patients in integrated model were more satisfied with overall care received in 6 of 8 domains (access, attention to patient preferences, courtesy, coordination, continuity, and overall care) (p < 0.05 on all 6 domains)

 

Gater 1997

Score on Client Satisfaction Questionnaire (range 1-4; low score indicates higher satisfaction).

1.86 vs. 2.23

Quality of care

Druss 2001

Delivery of preventive measures outlined in clinical guidelines.

Patients in integrated model (n = 59) more likely than in control group (n = 61) to receive 15 of 17 measures, (p < 0.01)

 

Gater 1997

Number of clinical needs met; and unmet.

2.62 vs. 1.60, (p < 0.001);

0.57 vs. 1.62 (p < 0.001)

  

Number of social needs met; and unmet.

1.83 vs. 1.49, (p = NS); 0.86 vs. 1.64 (p < 0.05)

 

Watts 2007

Patients who screened positive for depression and received treatment in accordance with guidelines.

From 1.1% to 11.2% vs. from 3.0% to 0.7%, (p < 0.001)

Utilisation of services

Bartels 2004

Mean number of mental health and substance abuse visits.

3.04 vs. 1.91 (p ≤ 0.001)

  

Appointment attendance.

71% vs. 48.8% (95% CI = 2.14 to 3.08)

 

Druss 2001

Patients who used a medical: Primary care service; Specialty service;

Emergency department;

Inpatient service.

54/59 (91.5%) vs. 44/61 (72.1%), (p = 0.006);

41/59 (69.5%) vs. 41/61 (67.2%), (p = 0.17);

7/59 (11.9%) vs. 16/61 (26.2%), (p = 0.04);

5/59 (8.5%) vs. 11/61 (18%), (p = 0.12)

  

Patients who used a mental health:

Outpatient service; Emergency department; Inpatient service.

58/59 (98.3%) vs. 61/61 (100%), (p = 0.31);

21/59 (35.6%) vs. 25/61 (41%), (p = 0.31);

8/59 (13.6%) vs. 10/61 (16.4%), (p = 0.66)

 

Willenbring 1999

Mean number of IOT visits in 2 years.

42.2 ± 29.1 vs. 17.4 ± 15.6, (p < 0.001)

  

Mean number of IOT visits in first and last 6 months of treatment.

From 14 to 9 vs. 4-6 in both periods

Access to health care

Watts 2007

Patients who screened positive and were able to access mental health services.

36.0% vs. 9%, (p < 0.001)

Cost

Druss 2001

Mean cost per subject treated

US$ 13,010 vs. US$ 14,543

 

Gater 1997

Overall per capita health service cost

£ 1,406 vs. £ 1,199

 

Weisner 2001

Average cost of all treatment per month

US$ 470.81 vs. US$ 427.95, (p = 0.14)