ISSN 2146-8346
 

Original Research 


Utilization patterns of substance abuse and mental health resources at an urban VA Hospital

Candace Tannis, Sritha Rajupet.

Abstract
Background: Over 10% of the 610,000 homeless persons in the United States are veterans. Homelessness is associated with more substance abuse and mental health diagnoses, and higher hospitalization rates. We assessed the mental health (MH) and substance abuse (SA) burden and use of outpatient MH and SA resources in a homeless veteran population.

Methods: Electronic medical record data were obtained on all homeless PACT team (HPACT) and non-homeless patients during fiscal years 2016 &2017. MH and SA prevalence, and related outpatient resource use were compared in three sub-populations: HPACT patients, non-HPACT patients with a homelessness ICD-10 code, and non-homeless PACT patients. Chi-square analyses and t-testing were performed to identify between-group differences during fiscal year 2018.

Results: HPACT and homeless, non-HPACT patients had higher MH and SA disorder prevalence, and MH/SA comorbidity in both years (p<.00001) with few significant changes from Year1 to Year2. PTSD clinic utilization among patients with PTSD increased from Year1 to Year2 for HPACT, non-HPACT homeless, and non-homeless patients (25% vs 4%, 25.9% vs 16.7%, 34% vs 25.2, p<0.01) with the greatest improvement among HPACT patients. Overall, outpatient MH service use increased from Year 1to Year 2, among patients with an MH diagnosis (77.3% vs 44.3%, 82.7% vs 54.2%, 69 vs 51.4%, p<0.001), with greater improvement in the HPACT and non-HPACT homeless patients. For those with an SA diagnosis, outpatient utilization rates doubled (52.5% vs 27%, 57.5% vs 27.7%, 35.2% vs 17.9%, p<0.001). HPACT and non-HPACT homeless patients were more likely to have a psychiatric hospitalization in Years 1 and 2, compared to non-homeless patients (5.8%/ 6.1% vs 6.7%/ 4.9% vs 1.1%/1%, p <0.00001). There was no change in psychiatric hospitalization rates from Year1 to Year2.

Conclusions: More research on MH and SA treatment strategies is needed to address the significant disease burden among homeless veterans.

Key words: Substance Abuse Mental Health Veterans Homeless


 
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How to Cite this Article
Pubmed Style

Tannis C, Rajupet S. Utilization patterns of substance abuse and mental health resources at an urban VA Hospital. J Behav Health. 2018; 7(4): 155-163. doi:10.5455/jbh.20180706050351


Web Style

Tannis C, Rajupet S. Utilization patterns of substance abuse and mental health resources at an urban VA Hospital. http://www.jbehavioralhealth.com/?mno=302758 [Access: May 21, 2019]. doi:10.5455/jbh.20180706050351


AMA (American Medical Association) Style

Tannis C, Rajupet S. Utilization patterns of substance abuse and mental health resources at an urban VA Hospital. J Behav Health. 2018; 7(4): 155-163. doi:10.5455/jbh.20180706050351



Vancouver/ICMJE Style

Tannis C, Rajupet S. Utilization patterns of substance abuse and mental health resources at an urban VA Hospital. J Behav Health. (2018), [cited May 21, 2019]; 7(4): 155-163. doi:10.5455/jbh.20180706050351



Harvard Style

Tannis, C. & Rajupet, . S. (2018) Utilization patterns of substance abuse and mental health resources at an urban VA Hospital. J Behav Health, 7 (4), 155-163. doi:10.5455/jbh.20180706050351



Turabian Style

Tannis, Candace, and Sritha Rajupet. 2018. Utilization patterns of substance abuse and mental health resources at an urban VA Hospital. Journal of Behavioral Health, 7 (4), 155-163. doi:10.5455/jbh.20180706050351



Chicago Style

Tannis, Candace, and Sritha Rajupet. "Utilization patterns of substance abuse and mental health resources at an urban VA Hospital." Journal of Behavioral Health 7 (2018), 155-163. doi:10.5455/jbh.20180706050351



MLA (The Modern Language Association) Style

Tannis, Candace, and Sritha Rajupet. "Utilization patterns of substance abuse and mental health resources at an urban VA Hospital." Journal of Behavioral Health 7.4 (2018), 155-163. Print. doi:10.5455/jbh.20180706050351



APA (American Psychological Association) Style

Tannis, C. & Rajupet, . S. (2018) Utilization patterns of substance abuse and mental health resources at an urban VA Hospital. Journal of Behavioral Health, 7 (4), 155-163. doi:10.5455/jbh.20180706050351





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