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October 2006, Vol 96, No. 10 | American Journal of Public Health 1785-1793
© 2006 American Public Health Association
DOI: 10.2105/AJPH.2005.072736

RESEARCH AND PRACTICE

Detection of Co-Occurring Mental Illness Among Adult Patients in the New Jersey Substance Abuse Treatment System

Hsou Mei Hu, PhD, MHS, Anna Kline, PhD, Frederick Y. Huang, MD and Douglas M. Ziedonis, MD, MPH

At the time of the study, Hsou Mei Hu and Frederick Y. Huang were with the Institute for Health, Health Care Policy, and Aging Research at Rutgers, The State University of New Jersey, New Brunswick. Anna Kline and Douglas M. Ziedonis are with the Department of Psychiatry, Division of Addiction Psychiatry, University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School, Piscataway.

Correspondence: Requests for reprints should be sent to Hsou Mei Hu, Division of General Medicine, University of Michigan Medical School, 300 North Ingalls, Suite 7C27, Ann Arbor, MI 48109–0429 (e-mail: hsoumei{at}gmail.com).

Objectives. We assessed the detection of mental illness in an adult population of substance abuse patients and the rate of referral for mental health treatment.

Methods. We obtained combined administrative records from 1994 to 1997 provided by the New Jersey substance abuse and mental health systems and estimated detection and referral rates of patients with co-occurring disorders (n = 47 379). Mental illness was considered detected if a diagnosis was in the record and considered undetected if a diagnosis was not in the record but the patient was seen in both treatment systems within the same 12-month period. Predictors of detection and referral were identified.

Results. The detection rate of co-occurring mental illness was 21.9% (n=10364); 57.9% (n=6001) of these individuals were referred for mental health treatment. Methadone maintenance clinics had the lowest detection rate but the highest referral rate. Male, Hispanic, and African American patients, as well as those who used heroin or were in the criminal justice system, had a higher risk of mental illness not being detected. Once detected, African American patients, heroin users, and patients in the criminal justice system were less likely to be referred for treatment.

Conclusions. There is a need to improve the detection of mental illness among substance abuse patients and to provide integrated treatment.






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