1. Chapter 11 Subset of Overview by Mental Health Disorders GAIN Coordinating Center (11/21/2012). Normal, IL: Chestnut Health Systems. November 2012. Available from www.gaincc.org/slideswww.gaincc.org/slides Created for: Substance Abuse and Mental Health Services Administration’s (SAMHSA) Center for Substance Abuse Treatment (CSAT) under contract number 270-2012-00001

2. 2 SAMHSA/CSAT Full GAIN Outcome Data Set Sample: The 2011 SAMHSA/CSAT data set includes data on 29,782 clients from 230 local evaluations, recruited between 1997-2011 who were due for at least one follow-up and available in the last quarterly data set of 2011. Levels of Care: Outpatient, Intensive Outpatient, Short-term & Moderate/Long-term Residential, Corrections-Based Treatment and Post-Treatment Continuing Care Instrument:Global Appraisal of Individual Needs (GAIN) (see www.gaincc.org/gaini) Versions 3 (CYT & ATM) and 5.1 through 5.6 www.gaincc.org/gaini Follow-up:89% with one or more follow-ups at 3, 6, 9 & 12 months post intake, and 66% with two or more Funding: SAMHSA/CSAT contracts 270-07-0191 and 270- 2012-00001 and 230 individual grants (see Detailed Acknowledgement)

3. 3 Past Year Pattern of Mental Health Disorders Internalizing Disorders Only 9.3% (n=2,770) Externalizing Disorders Only 20.6% (n=6,128) Both 32.8% (n=9,727) Neither 37.3% (n=11,059) SAMHSA 2011 GAIN Summary Analytic Data Set (n=29,684)

4. 4 Risk and Protective Factors by Mental Health Disorders  The following slides present information on demographics, and risk and protective factors by different age groups for clients at intake, including:  Demographics  Substance use  Risk behaviors  Victimization  Mental health disorders  Physical health problems  Crime and violence  Sources of stress and strengths  Costs  Summary indices (problem prevalence, quality of life, general satisfaction)  Non-client characteristics (program, level of care, and type of treatment)

5. 5 Age by Mental Health Disorders SAMHSA 2011 GAIN Summary Analytic Data Set (n=29,684)

6. 6 Gender by Mental Health Disorders SAMHSA 2011 GAIN Summary Analytic Data Set (n=29,673)

7. 7 Race by Mental Health Disorders SAMHSA 2011 GAIN Summary Analytic Data Set (n=29,669)

8. 8 8 Risk of Homelessness by Mental Health Disorders SAMHSA 2011 GAIN Summary Analytic Data Set (n=29,549)

9. 9 Past Year Substance Severity by Mental Health Disorders SAMHSA 2011 GAIN Summary Analytic Data Set (n=29,287)

10. 10 Primary Substance by Mental Health Disorders SAMHSA 2011 GAIN Summary Analytic Data Set (n=27,630)

11. 11 Number of Substance Problems by Mental Health Disorders SAMHSA 2011 GAIN Summary Analytic Data Set (n=27,631)

12. 12 Tobacco Diagnosis by Mental Health Disorders SAMHSA 2011 GAIN Summary Analytic Data Set (n=27,326)

13. 13 HIV Risk Scale* by Mental Health Disorders * Available at intake only. SAMHSA 2011 GAIN Summary Analytic Data Set (n=29,684)

14. 14 HIV Risk Change Index* by Mental Health Disorders *Can be used to measure change. SAMHSA 2011 GAIN Summary Analytic Data Set (n=26,802)

15. 15 Number of Sex Partners* by Mental Health Disorders *In the past 90 days SAMHSA 2011 GAIN Summary Analytic Data Set (n=28,697)

16. 16 Severity of Victimization by Mental Health Disorders SAMHSA 2011 GAIN Summary Analytic Data Set (n=29,455)

17. 17 Homicidal/Suicidal Thoughts by Mental Health Disorders SAMHSA 2011 GAIN Summary Analytic Data Set (n=29,424)

18. 18 Health Problems by Mental Health Disorders SAMHSA 2011 GAIN Summary Analytic Data Set (n=29,414)

19. 19 Health Care Utilization Cost* by Mental Health Disorders *Using 2011 Dollars SAMHSA 2011 GAIN Summary Analytic Data Set (n=28,449)

20. 20 Crime and Violence by Mental Health Disorders SAMHSA 2011 GAIN Summary Analytic Data Set (n=29,661)

21. 21 Type of Crime by Mental Health Disorders SAMHSA 2011 GAIN Summary Analytic Data Set (n=29,347) * Violent crime includes assault, rape, murder, and arson. ** Other crime includes vandalism, possession of stolen goods, forgery, and theft.

22. 22 Cost of Crime* by Mental Health Disorders *Using 2011 Dollars SAMHSA 2011 GAIN Summary Analytic Data Set (n=27,374)

23. 23 Intensity of Justice System Involvement by Mental Health Disorders SAMHSA 2011 GAIN Summary Analytic Data Set (n=29,574)

24. 24 Count of Major Clinical Problems* at Intake by Mental Health Disorders *Based on count of self reporting criteria to suggest alcohol, cannabis, or other drug disorder, depression, anxiety, trauma, suicide, ADHD, CD, victimization, violence/ illegal activity SAMHSA 2011 GAIN Summary Analytic Data Set (n=29,684)

25. 25 Sources of Stress Index by Mental Health Disorders SAMHSA 2011 GAIN Summary Analytic Data Set (n=12,562)

26. 26 Treatment Readiness by Mental Health Disorders SAMHSA 2011 GAIN Summary Analytic Data Set (n=28,272)

27. 27 Self-Help Activity by Mental Health Disorders SAMHSA 2011 GAIN Summary Analytic Data Set (n=8,326)

28. 28 Strength Self-Efficacy Index by Mental Health Disorders SAMHSA 2011 GAIN Summary Analytic Data Set (n=12,737)

29. 29 General Social Support Index by Mental Health Disorders SAMHSA 2011 GAIN Summary Analytic Data Set (n=14,687)

30. 30 Spiritual Social Support by Mental Health Disorders SAMHSA 2011 GAIN Summary Analytic Data Set (n=12,446)

31. 31 Environmental Strengths Index by Mental Health Disorders SAMHSA 2011 GAIN Summary Analytic Data Set (n=27,580)

32. 32 Quarterly Cost to Society* by Mental Health Disorders SAMHSA 2011 GAIN Summary Analytic Data Set (n=26,668) *Using 2011 Dollars

33. 33 Problem Prevalence Index by Mental Health Disorders SAMHSA 2011 GAIN Summary Analytic Data Set (n=27,568)

34. 34 Quality of Life by Mental Health Disorders SAMHSA 2011 GAIN Summary Analytic Data Set (n=22,096)

35. 35 General Satisfaction by Mental Health Disorders SAMHSA 2011 GAIN Summary Analytic Data Set (n=12,250)

36. 36 Program by Mental Health Disorders SAMHSA 2011 GAIN Summary Analytic Data Set (n=29,684)

37. 37 Level of Care by Mental Health Disorders SAMHSA 2011 GAIN Summary Analytic Data Set (n=28,651)

38. 38 Type of Treatment by Mental Health Disorders SAMHSA 2011 GAIN Summary Analytic Data Set (n=28,789)

39. 39 Outcomes  The following slides present information on the outcomes of substance abuse treatment by mental health disorders, including:  Abstinence  Recovery  GPRA outcomes (vocationally engaged, housed, no justice system involvement, social consequences, abstinence, and social connectedness) and  NOMS outcomes (treatment initiation, engagement and continuing care; no problems with: health, mental health, family, illegal activity; abstinent, vocationally engaged and housed).  Data on follow up rates, months to last follow up, and number of follow ups per client are provided in the Methods Appendix.Methods Appendix

40. 40 Percent Change in 6 Month Abstinence by Mental Health Disorders SAMHSA 2011 GAIN SA Data Set subset to 6 Month Follow up (n=20,135)

41. 41 Relative Percent Change in 6 Month Abstinence by Mental Health Disorders SAMHSA 2011 GAIN SA Data Set subset to 6 Month Follow up (n=20,135)

42. 42 Past Month AOD Abstinence by Mental Health Disorders *Interpolated SAMHSA 2011 GAIN SA Data Set subset to 1+ Follow ups

43. 43 Recovery* by Mental Health Disorders * Recovery defined as no past month use, abuse, or dependence symptoms while living in the community. SAMHSA 2011 GAIN SA Data Set subset to 1+ Follow ups **Interpolated

44. 44 Change in GPRA Outcomes by Mental Health Disorders (Intake to Last Wave*) Neither Externalizing Disorders Only Both Internalizing Disorders Only *Last wave is the last follow-up SAMHSA 2011 GAIN SA Data Set subset to 1+ Follow ups

45. 45 NOMS Outcome: Number of Treatment Received Outcomes Met* by Mental Health Disorders *Based on a count of initiation within 14 days, evidence based practice, engagement for at least 6 weeks, and any continuing care. SAMHSA 2011 GAIN SA Data Set subset to 1+ Follow ups (n=24,564)

46. 46 SAMHSA Outcome: Treatment Cost Bands by Mental Health Disorders SAMHSA 2011 GAIN SA Data Set subset to 1+ Follow ups (n=17,822)

47. 47 Change in Selected NOMS Outcomes by Mental Health Disorders (Intake to Last Wave) Externalizing Only Internalizing Only Neither Both *Past monthSAMHSA 2011 GAIN SA Data Set subset to 1+ Follow ups

48. 48 NOMS Outcomes: Count of Positive Outcomes (Last FU–Intake) by Mental Health Disorders SAMHSA 2011 GAIN SA Data Set subset to 1+ Follow ups (n=25,452)