Chapter 10 Subset of Overview by Severity of Victimization

Chapter 10Subset of Overview by Severity of Victimization

GAIN Coordinating Center (11/21/2012).

Normal, IL: Chestnut Health Systems. November 2012. Available from www.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

http://www.gaincc.org/slides

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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

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)

http://www.gaincc.org/gaini

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Lifetime Severity of Victimization

High Severity 45.9%

(n=13,546)

Low Severity 35.1%

(n=10,360)

Moderate Severity 19.0%

(n=5,595)

SAMHSA 2011 GAIN Summary Analytic Data Set (n=29,501)

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Risk and Protective Factors by Severity of Victimization

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)

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Age by Severity of Victimization

Low Severity Moderate Sever-ity

High Severity0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

6% 9% 12%11%

14% 15%

67%63% 61%

16% 14% 12%

<15

15-17

18-25

26+


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Gender by Severity of Victimization


High Severity0%

10%20%30%40%50%60%70%80%90%

100%

25% 18%34%

75% 82%66% Male

Female


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Race by Severity of Victimization


High Severity0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

20% 17% 12%

29% 31%27%

4% 3%4%

37% 37%40%

11% 12% 16%Multi-Racial

White

Other

Hispanic

African American


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Risk of Homelessness by Severity of Victimization

Low Severity Moderate Severity

High Severity0%

10%20%30%40%50%60%70%80%90%

100%

85% 78%67%

1% 3% 7%Currently Homeless

At Risk of Homeless-ness

Group/Inst

Housed


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Past Year Substance Severity by Severity of Victimization


High Severity0%

10%20%30%40%50%60%70%80%90%

100%

32%47%

60%

PY De-pendence

PY Abuse

PY Use

No PY Use


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Primary Substance by Severity of Victimization

LowSeverity

ModerateSeverity

HighSeverity

0%10%20%30%40%50%60%70%80%90%

100%

28% 25% 26%

59% 58% 49%

Other Drug

Opioids

Amphetamines

Cocaine

Marijuana

Alcohol


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High Severity0%

10%20%30%40%50%60%70%80%90%

100%11% 21%

33% High SU (6-8)

Moderate SU (3-5)

Low SU (0-2)

Number of Substance Problems by Severity of Victimization


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High Severity0%

10%20%30%40%50%60%70%80%90%

100%

29%39% 45%

Dependence/Daily Use

Current PY Use

Past Use

Never Used

Tobacco Diagnosis by Severity of Victimization


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HIV Risk Scale* by Severity of Victimization

* Available at intake only.


High Severity0%

10%20%30%40%50%60%70%80%90%

100% 1%

43%High Risk(10-36)

Moderate Risk(3-9)

Low Risk(0-2)


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HIV Risk Change Index* bySeverity of Victimization

*Can be used to measure change.


High Severity0%

10%20%30%40%50%60%70%80%90%

100% 5%17% High

Risk(4-7)

ModerateRisk(2-3)

LowRisk(0-1)


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Number of Sex Partners* by Severity of Victimization


High Severity0%

10%20%30%40%50%60%70%80%90%

100%11% 16% 19%

3+ Sex Partners

1-2 Sex Partners

No Sex Partners

*In the past 90 days


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Mental Health Disorders by Severity of Victimization


High Severity0%

10%20%30%40%50%60%70%80%90%

100%14%

25%

51%

Both

Internalizing Disorders Only

Externalizing Disorders Only

Neither


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High Severity0%

10%20%30%40%50%60%70%80%90%

100% 1% 2% 5%High Severity(4-5)

Moderate Severity (1-3)

Low Severity (0)

Homicidal/Suicidal Thoughts by Severity of Victimization


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Health Problems by Severity of Victimization


High Severity0%

10%20%30%40%50%60%70%80%90%

100% 6% 7% 12%High Problems(33-100)

Moderate Problems (10-32)

Low Prob-lems(0-9)


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Health Care Utilization Cost* by Severity of Victimization

*Using 2011 Dollars

Low Victim-ization

Moderate Victimization

High Victim-ization

0%10%20%30%40%50%60%70%80%90%

100%

$0

$500

$1,000

$1,500

$2,000

$2,500

$3,000

$3,500

$4,000

$1,511

$2,116

$3,483$7,600+

$1-$7,599

$0

Mean


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Crime and Violence by Severity of Victimization


High Severity0%

10%20%30%40%50%60%70%80%90%

100%15%

35%50%

High Crime(7-29)

Moderate Crime (3-6)

Low Crime(0-2)


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Type of Crime by Severity of Victimization


High Severity0%

10%20%30%40%50%60%70%80%90%

100%20%

40% 50%Violent Crime*

Other Crime**

Drug Use only


* Violent crime includes assault, rape, murder, and arson.** Other crime includes vandalism, possession of stolen goods, forgery, and theft.

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Cost of Crime* by Severity of Victimization

*Using 2011 Dollars

Low Sever-ity

Moderate Severity

High Sever-ity

0%10%20%30%40%50%60%70%80%90%

100%

$0$100,000$200,000$300,000$400,000$500,000$600,000$700,000$800,000$900,000$1,000,000

$78,867$277,291

$977,567$120,000+

$1-$119,000

$0

Mean


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High Severity0%

10%20%30%40%50%60%70%80%90%

100%Detention/jail 30+ daysDetention/jail 14-29 daysDrug CourtProb/parole 14+ days w/ 1+ drug screensOther probation, parole, detentionOther JJ/CJ statusPast arrest/JJ/CJ sta-tusPast yr illegal activity/SA use

Intensity of Justice System Involvement by Severity of Victimization


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Count of Major Clinical Problems* at Intake by Severity of Victimization


High Severity0%

10%20%30%40%50%60%70%80%90%

100%16%

46%71%

Five to Twelve

Four

Three

Two

One

None


*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

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High Severity0%

10%20%30%40%50%60%70%80%90%

100%17%

30%

55%

High Stress(3-15)

Moderate Stress(1-2)

Low Stress(0)

Sources of Stress Index by Severity of Victimization


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High Severity0%

10%20%30%40%50%60%70%80%90%

100% 5% 6% 5%High Readiness (6-9)

ModerateReadiness (3-5)

Low Readiness (0-2)

Treatment Readiness by Severity of Victimization


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Self-Help Activity by Severity of Victimization


High Severity0%

10%20%30%40%50%60%70%80%90%

100%

85%75%

64%

Low Ac-tivity (0)

Moderate Activity (1-11)

High Ac-tivity (12-19)


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High Severity0%

10%20%30%40%50%60%70%80%90%

100%10% 7% 6%

Low Strength(0-2)

Moderate Strength (3-6)

High Strength (7-10)

Strength Self-Efficacy Index by Severity of Victimization


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High Severity0%

10%20%30%40%50%60%70%80%90%

100% 9% 6% 5%Low Support(0-1)

Moderate Support (2-4)

High Support(5-9)

General Social Support Index by Severity of Victimization


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Spiritual Social Support by Severity of Victimization


High Severity0%

10%20%30%40%50%60%70%80%90%

100%

55% 52% 47%

Low Support (0-2)

Moderate Support (3-5)

High Support (6-7)


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High Severity0%

10%20%30%40%50%60%70%80%90%

100% 7% 8% 8%Low Strength(0-2)

Moderate Strength (3-5)

High Strength(12-16)

Environmental Strengths Index by Severity of Victimization


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Quarterly Cost to Society* by Severity of Victimization

*Using 2011 Dollars

Low Severity

Moderate Severity

High Sever-ity

0%10%20%30%40%50%60%70%80%90%

100%

$0$1,000$2,000$3,000$4,000$5,000$6,000$7,000$8,000$9,000$10,000$11,000

$3,260 $4,466

$6,435

$10,000+

$2,000 - $9,999

$0 - $1,999

Mean


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Problem Prevalence Index by Severity of Victimization

Low Severity

Moderate Severity

High Severity

0%10%20%30%40%50%60%70%80%90%

100% 2% 5% 13%High Preva-lence(25-100)

Moderate Prevalence (6-24)

Low Preva-lence(0-5)


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High Severity0%

10%20%30%40%50%60%70%80%90%

100%10%

27%

52%Low Qual-ity (0-36)

Moderate Quality (37-69)

High Quality(70-100)

Quality of Life by Severity of Victimization


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General Satisfaction by Severity of Victimization


High Severity0%

10%20%30%40%50%60%70%80%90%

100% 9% 10% 19% Low Satis-faction (0-2)

Moderate Satisfaction (3-4)

High Satis-faction(5-6)


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Program by Severity of Victimization


High Severity0%

10%20%30%40%50%60%70%80%90%

100%ATMARTCYTYORPORPATDCSCYAAFTDCEATTCEOther


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Level of Care by Severity of Victimization


High Severity0%

10%20%30%40%50%60%70%80%90%

100%

78% 72% 65%

11% 14%14%

5% 6%9%

5% 7% 11%1% 2%

STR

M-LTR

CC-OP

IOP

OP


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Type of Treatment by Severity of Victimization


High Severity0%

10%20%30%40%50%60%70%80%90%

100%

44% 36% 31%

12%12%

10%

27%30%

29%

13% 18%21%

4% 5% 8%Tx Man

Other

ACRA/ACC

Other EBTx

MET/CBT


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Outcomes The following slides present information on the outcomes of

substance abuse treatment by severity of victimization, 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.

http://gaincc.org/_data/files/Posting_Publications/19._Methods_Appendix_2011.pptx

http://gaincc.org/_data/files/Posting_Publications/19._Methods_Appendix_2011.pptx

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Percent Change in 6 Month Abstinence by Severity of Victimization

Low Severity Moderate Severity High Severity0%

10%20%30%40%50%60%70%80%90%

100%

22% 21% 17%

SAMHSA 2011 GAIN SA Data Set subset to 6 Month Follow up (n=19,960)

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Relative Percent Change in 6 Month Abstinence by Severity of Victimization

Low Severity Moderate Severity High Severity0%

10%20%30%40%50%60%70%80%90%

100%

50% 53%40%

SAMHSA 2011 GAIN SA Data Set subset to 6 Month Follow up (n=19,960)

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Past Month AOD Abstinence by Severity of Victimization

Intake 3 Month 6 Month 9 Month* 12 Month0%

10%20%30%40%50%60%70%80%90%

100%

Low Severity (0)

Moder-ate Severity (1-3)

High Severity (4-15)

*InterpolatedSAMHSA 2011 GAIN SA Data Set subset to 1+ Follow ups

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Recovery* by Severity of Victimization

Intake 3 Month 6 Month 9 Month** 12 Month0%

10%20%30%40%50%60%70%80%90%

100%

Low Severity (0)

Moderate Severity (1-3)

High Severity (4-15)

* 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

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Change in GPRA Outcomes by Severity of Victimization (Intake to Last Wave*)

Inta

ke

Last

W

ave

Inta

ke

Last

W

ave

Inta

ke

Last

W

ave0%

10%20%30%40%50%60%70%80%90%

100%Vocationally Engaged

Housing

No Justice Sys-tem Involvement

No Social Conse-quencesAbstinence

Socially ConnectedLow

SeverityModerate Severity

High Severity

*Last wave is the last follow-upSAMHSA 2011 GAIN SA Data Set subset to 1+ Follow ups

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NOMS Outcome: Number of Treatment Received Outcomes Met* by Severity of Victimization


High Severity0%

10%20%30%40%50%60%70%80%90%

100%

31% 30% 30%

40% 41% 41%

None

One

Two

Three

Four

*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=24,381)

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SAMHSA Outcome: Treatment Cost Bands by Severity of Victimization


High Severity0%

10%20%30%40%50%60%70%80%90%

100%

52% 49% 45%

Above

Within

Below

SAMHSA 2011 GAIN SA Data Set subset to 1+ Follow ups (n=17,628)

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Change in Selected NOMS Outcomes by Severity of Victimization (Intake to Last Wave)

Inta

ke

Last

W

ave

Inta

ke

Last

W

ave

Inta

ke

Last

W

ave0%

10%20%30%40%50%60%70%80%90%

100%No Health Prob-lems

No Mental Health Problems

No Family Prob-lems

Abstinence

No Illegal Activ-ity

Vocationally Engaged*

Housed

Low Severity Mod Severity High Severity

*Past monthSAMHSA 2011 GAIN SA Data Set subset to 1+ Follow ups

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NOMS Outcomes: Count of Positive Outcomes (Last FU–Intake) by Severity of Victimization

Low Severity(73% w/ 1+)

Moderate Severity(78% w/ 1+)

High Severity(80% w/ 1+)

0%10%20%30%40%50%60%70%80%90%

100%

22% 29% 32%

Less than negative one

Negative one

None

One

Two

Three

Four

Five +

SAMHSA 2011 GAIN SA Data Set subset to 1+ Follow ups (n=25,268)

Chapter 10 Subset of Overview by Severity of Victimization

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