OBJECTIVES: This study examined the relationship between substance abuse
patients' length of stay in community residential facilities and their
outpatient mental health aftercare and readmission for inpatient care.
METHODS: A national sample of 1,070 substance abuse patients referred to
community residential facilities after an episode of inpatient care was
assessed and followed over four years. Patients were divided into three
groups: those with only alcohol-related diagnoses; those with drug-related
diagnoses, most of whom also had alcohol diagnoses; and those with
concomitant psychiatric diagnoses. RESULTS: Patients who had longer
episodes of care in residential facilities were more likely to obtain
outpatient mental health aftercare and were less likely to be readmitted
for additional substance abuse or psychiatric care in six-month, one-year,
and four-year follow-up intervals. Readmission rates among substance abuse
patients with psychiatric diagnoses were much higher than rates among
patients who had only substance abuse diagnoses. Length of stay in the
community residential facility and postdischarge outpatient mental health
care remained significant independent predictors of lower readmission after
other risk factors for readmission were considered. CONCLUSIONS:
Transitional community residential care can contribute to substance abuse
patients' treatment outcome; however, longer-term supportive care is needed
for substance abuse patients with more severe and chronic disorders.
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