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Table 3 Bivariate comparison of service utilization and psychotropic prescription fills among veterans in community care treatment and mental health clinics only

From: Social determinants of mental health care systems: intensive community based Care in the Veterans Health Administration

  Mental Health Clinic (1) Vocational (2) Homelessness (3) Criminal Justice (4) SMI Services (5) 2 vs 1 3 vs 1 4 vs 1 5 vs 1
N= 1,134,377 20,921 160,273 42,985 27,931 Effect Size
  Mean SD Mean SD Mean SD Mean SD Mean SD Cohen d
General psychiatry visits 5.81 9.27 15.96 22.89 16.51 24.43 11.83 22.54 67.37 74.42 0.602 0.634 0.357 3.650
General psychiatry visits excluding community-based programs 5.81 9.27 10.60 20.01 8.04 19.65 6.00 16.69 15.98 28.61 0.389 0.181 0.016 0.826
Substance abuse clinic visits 0.90 7.91 7.76 25.47 8.08 26.01 8.31 24.94 7.17 25.34 0.515 0.539 0.556 0.471
Medical surgical visits 9.60 11.12 10.66 11.40 10.07 11.76 9.54 12.27 13.45 14.53 0.092 0.040 −0.006 0.334
 Primary care visits 3.43 3.50 4.02 3.86 3.93 4.24 3.27 3.96 4.71 5.08 0.156 0.134 −0.044 0.344
 Specialty medical clinic visits 6.17 9.35 6.64 9.40 6.14 9.52 6.26 10.16 8.74 12.12 0.049 −0.003 0.010 0.267
Emergency room visits 0.60 1.58 1.06 2.32 1.37 2.97 1.22 2.67 1.87 4.13 0.232 0.388 0.313 0.644
  % N % N % N % N % N Risk Ratio
Any mental health inpatient treatment 2.8 32,134 8.0 1674 10.3 16,581 9.4 4029 25.2 7037 2.825 3.652 3.309 8.894
Any medical surgical inpatient treatment 7.9 90,143 8.7 1814 11.6 18,563 12.0 5154 14.3 4007 1.091 1.458 1.509 1.805
Psychotropic medication prescriptions Mean SD Mean SD Mean SD Mean SD Mean SD Cohen d
 Antidepressant prescriptions 5.67 9.79 6.45 16.22 5.84 13.63 5.26 13.52 12.37 25.31 0.069 0.015 −0.037 0.595
Antipsychotic prescriptions 1.76 8.09 2.65 11.73 2.53 10.53 2.06 9.29 16.41 35.24 0.089 0.077 0.030 1.467
 Anxiolytic/sedative/hypnotic prescriptions 2.90 5.64 2.29 6.57 1.92 5.71 1.78 5.33 4.77 9.73 −0.104 −0.167 −0.192 0.318
 Stimulant prescriptions 0.16 1.28 0.20 3.52 0.10 1.74 0.10 1.38 0.13 1.32 0.024 −0.042 −0.042 −0.024
 Anticonvulsant/Mood Stabilizer Prescriptions 1.55 6.09 2.08 8.64 2.19 9.04 2.04 9.04 7.12 21.19 0.072 0.087 0.067 0.756
 Lithium prescriptions 0.13 1.65 0.25 2.51 0.21 2.51 0.18 2.18 1.47 9.95 0.052 0.033 0.022 0.577
 All Psychotropics 13.03 21.03 14.74 33.21 14.40 30.33 13.85 30.64 43.05 70.05 0.068 0.054 0.033 1.189
 Opiate Prescriptions 7.51 7.50 6.72 7.70 7.20 8.32 6.81 8.61 7.49 9.38 −0.101 −0.040 −0.090 −0.002
Intensive community treatment programs Mean SD Mean SD Mean SD Mean SD Mean SD Cohen d
 SMI Services 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 46.58 67.38 n/a n/a n/a n/a
 Criminal justice outreach, jail diversion visits 0.00 0.00 0.00 0.00 0.00 0.00 2.45 4.27 0.19 1.64 n/a n/a n/a n/a
 Homelessness visits 0.00 0.00 0.00 0.00 7.49 10.95 2.70 8.45 3.30 10.08 n/a n/a n/a n/a
 Vocational rehabilitation visits 0.00 0.00 5.36 9.63 1.54 5.93 1.03 5.05 1.56 6.08 n/a n/a n/a n/a
Total intensive community treatment visits 0.00 0.00 5.36 9.63 9.04 13.41 6.18 12.46 51.63 68.38 n/a n/a n/a n/a