Transcript Document

Chapter 6
Subset of Overview by
Gender
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
SAMHSA/CSAT Full GAIN Outcome
Data Set
2
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 2702012-00001 and 230 individual grants
(see Detailed Acknowledgement)
Gender
3
Females
27%
(n= 8,172)
Other
0.03%
(n=10)
Males 73%
(n=21,599)
SAMHSA 2011 GAIN Summary Analytic Data Set (n=29,781)
Risk and Protective Factors by Gender
4
 The following slides present information on
demographics, and risk and protective factors by
different age groups for clients at intake, including:
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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)
Age by Gender
5
100%
90%
13%
16%
<15
80%
70%
15-17
60%
50%
66%
57%
40%
18-25
30%
14%
20%
10%
0%
13%
8%
Male
26+
14%
Female
SAMHSA 2011 GAIN Summary Analytic Data Set (n=29,771)
Race by Gender
6
100%
90%
13%
16%
MultiRacial
80%
70%
46%
60%
50%
31%
5%
Hispanic
24%
20%
10%
Other
4%
40%
30%
White
35%
18%
0%
Male
10%
Female
SAMHSA 2011 GAIN Summary Analytic Data Set (n=29,757)
African
American
Risk of Homelessness by Gender
7
100%
3%
7%
90%
Currently
Homeless
80%
70%
At Risk of
Homelessness
60%
50%
40%
76%
Group/Inst
71%
30%
20%
Housed
10%
0%
Male
Female
SAMHSA 2011 GAIN Summary Analytic Data Set (n=29,635)
Past Year Substance Severity by Gender
8
100%
90%
80%
PY
Dependence
46%
70%
54%
PY Abuse
60%
50%
40%
PY Use
30%
20%
No PY Use
10%
0%
Male
Female
SAMHSA 2011 GAIN Summary Analytic Data Set (n=29,348)
Primary Substance by Gender
9
100%
Other Drug
90%
80%
Opioids
70%
60%
50%
60%
Amphetamines
39%
Cocaine
40%
30%
Marijuana
20%
10%
25%
31%
Alcohol
0%
Male
Female
SAMHSA 2011 GAIN Summary Analytic Data Set (n=27,706)
Number of Substance Problems by Gender
10
100%
90%
22%
26%
80%
High SU
(6-8)
70%
60%
Moderate
SU (3-5)
50%
40%
30%
20%
Low SU
(0-2)
10%
0%
Male
Female
SAMHSA 2011 GAIN Summary Analytic Data Set (n=27,706)
Tobacco Diagnosis by Gender
11
100%
Dependence
/Daily Use
90%
80%
36%
44%
70%
Current PY
Use
60%
50%
Past Use
40%
30%
20%
Never Used
10%
0%
Male
Female
SAMHSA 2011 GAIN Summary Analytic Data Set (n=27,373)
HIV Risk Scale* by Gender
12
100%
90%
16%
32%
80%
High
Risk
(10-36)
70%
60%
Moderate
Risk
(3-9)
50%
40%
30%
Low
Risk
(0-2)
20%
10%
0%
Male
Female
* Available at intake only.
SAMHSA 2011 GAIN Summary Analytic Data Set (n=29,735)
HIV Risk Change Index* by
Gender
13
100%
90%
8%
12%
80%
70%
60%
High
Risk
(4-7)
Moderate
Risk
(2-3)
50%
40%
30%
Low
Risk
(0-1)
20%
10%
0%
Male
Female
*Can be used to measure change.
SAMHSA 2011 GAIN Summary Analytic Data Set (n=26,824)
Number of Sex Partners* by Gender
14
100%
90%
10%
18%
3+ Sex
Partners
80%
70%
60%
1-2 Sex
Partners
50%
40%
30%
No Sex
Partners
20%
10%
0%
Male
Female
*In the past 90 days
SAMHSA 2011 GAIN Summary Analytic Data Set (n=28,740)
Severity of Victimization by Gender
15
100%
90%
80%
High
Severity
(4-15)
42%
56%
70%
60%
Moderate
Severity
(1-3)
50%
40%
30%
Low
Severity
(0)
20%
10%
0%
Male
Female
SAMHSA 2011 GAIN Summary Analytic Data Set (n=29,490)
Mental Health Disorders by Gender
16
100%
90%
Both
27%
80%
47%
70%
Internalizing
Disorders
Only
60%
50%
30%
Externalizing
Disorders
Only
20%
Neither
40%
10%
0%
Male
Female
SAMHSA 2011 GAIN Summary Analytic Data Set (n=29,673)
Homicidal/Suicidal Thoughts by
Gender
17
100%
2%
6%
90%
80%
High
Severity
(4-5)
70%
60%
Moderate
Severity
(1-3)
50%
40%
30%
Low
Severity
(0)
20%
10%
0%
Male
Female
SAMHSA 2011 GAIN Summary Analytic Data Set (n=29,458)
Health Problems by Gender
18
100%
7%
90%
14%
80%
High
Problems
(33-100)
70%
60%
Moderate
Problems
(10-32)
50%
40%
30%
Low
Problems
(0-9)
20%
10%
0%
Male
Female
SAMHSA 2011 GAIN Summary Analytic Data Set (n=29,467)
Health Care Utilization Cost* by Gender
19
100%
$4,000
90%
$3,767
80%
$3,500
$3,000
70%
60%
$2,500
50%
$2,000
$2,055
40%
$1,500
30%
$1 $7,599
$0
$1,000
20%
$500
10%
0%
$7,600+
Male
Female
*Using 2011 Dollars
SAMHSA 2011 GAIN Summary Analytic Data Set (n=28,471)
$0
Mean
Crime & Violence by Gender
20
100%
90%
80%
36%
32%
High
Crime
(7-29)
70%
60%
Moderate
Crime
(3-6)
50%
40%
30%
Low
Crime
(0-2)
20%
10%
0%
Male
Female
SAMHSA 2011 GAIN Summary Analytic Data Set (n=29,692)
Type of Crime by Gender
21
100%
90%
80%
30%
41%
Violent
Crime*
70%
60%
Other
Crime**
50%
40%
30%
20%
Drug
Use only
10%
0%
Male
Female
* Violent crime includes assault, rape, murder, and arson.
** Other crime includes vandalism, possession of stolen goods, forgery, and
theft.
SAMHSA 2011 GAIN Summary Analytic Data Set (n=29,366)
Cost of Crime* by Gender
22
100%
$700,000
$635,586
$120,000+
90%
$600,000
80%
$500,000
70%
60%
$400,000
$1$119,000
$300,000
$0
50%
40%
$235,523
30%
$200,000
20%
$100,000
10%
0%
Male
Female
*Using 2011 Dollars
SAMHSA 2011 GAIN Summary Analytic Data Set (n=27,394)
$0
Mean
Intensity of Justice System Involvement
by Gender
23
100%
Detention/jail 30+
days
Detention/jail 14-29
days
Drug Court
90%
80%
70%
60%
Prob/parole 14+ days
w/ 1+ drug screens
Other probation,
parole, detention
Other JJ/CJ status
50%
40%
30%
20%
10%
0%
Male
Female
SAMHSA 2011 GAIN Summary Analytic Data Set (n=29,606)
Past arrest/JJ/CJ
status
Past yr illegal
activity/SA use
Count of Major Clinical Problems*
at Intake by Gender
24
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
43%
Five to
Twelve
Four
56%
Three
Two
One
None
Male
Female
*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=29,771)
Sources of Stress Index by Gender
25
100%
90%
80%
31%
50%
70%
60%
High
Stress
(3-15)
Moderate
Stress
(1-2)
50%
40%
30%
Low
Stress
(0)
20%
10%
0%
Male
Female
SAMHSA 2011 GAIN Summary Analytic Data Set (n=12,588)
Treatment Readiness by Gender
26
100%
5%
4%
90%
Low
Readiness
(0-2)
80%
70%
60%
Moderate
Readiness
(3-5)
50%
40%
30%
High
Readiness
(6-9)
20%
10%
0%
Male
Female
SAMHSA 2011 GAIN Summary Analytic Data Set (n=28,334)
Self-Help Activities by Gender
27
100%
90%
Low
Activity
(0)
80%
70%
60%
65%
77%
Moderate
Activity
(1-11)
50%
40%
30%
High
Activity
(12-19)
20%
10%
0%
Male
Female
SAMHSA 2011 GAIN Summary Analytic Data Set (n=8,340)
Strength Self-Efficacy Index by Gender
28
100%
7%
8%
90%
Low
Strength
(0-2)
80%
70%
60%
Moderate
Strength
(3-6)
50%
40%
30%
High
Strength
(7-10)
20%
10%
0%
Male
Female
SAMHSA 2011 GAIN Summary Analytic Data Set (n=12,762)
General Social Support Index by
Gender
29
100%
7%
5%
90%
Low
Support
(0-1)
80%
70%
60%
Moderate
Support
(2-4)
50%
40%
30%
High
Support
(5-9)
20%
10%
0%
Male
Female
SAMHSA 2011 GAIN Summary Analytic Data Set (n=14,713)
Spiritual Social Support by Gender
30
100%
90%
80%
70%
51%
50%
60%
Low
Support
(0-2)
Moderate
Support
(3-5)
50%
40%
30%
High
Support
(6-7)
20%
10%
0%
Male
Female
SAMHSA 2011 GAIN Summary Analytic Data Set (n=12,472)
Environmental Strengths Index by
Gender
31
100%
7%
90%
9%
80%
Low
Strength
(0-2)
70%
60%
Moderate
Strength
(3-5)
50%
40%
30%
High
Strength
(12-16)
20%
10%
0%
Male
Female
SAMHSA 2011 GAIN Summary Analytic Data Set (n=27,614)
Quarterly Cost to Society* by Gender
32
100%
$11,000
90%
$10,000
80%
$9,000
70%
$8,000
$7,000
60%
$6,000
50%
40%
$5,961
30%
$3,000
20%
$2,000
10%
0%
$1,000
Male
Female
*Using 2011 Dollars
SAMHSA 2011 GAIN Summary Analytic Data Set (n=26,681)
$2,000 $9,999
$5,000
$4,000
$4,539
$10,000+
$0
$0-$1,999
Mean
Problem Prevalence Index by Gender
33
100%
6%
90%
10%
High
Prevalence
(25-100)
80%
70%
60%
Moderate
Prevalence
(6-24)
50%
40%
30%
Low
Prevalence
(0-5)
20%
10%
0%
Male
Female
SAMHSA 2011 GAIN Summary Analytic Data Set (n=27,595)
Quality of Life by Gender
34
100%
90%
80%
30%
40%
Low
Quality
(0-36)
70%
60%
Moderate
Quality
(37-69)
50%
40%
30%
High
Quality
(70-100)
20%
10%
0%
Male
Female
SAMHSA 2011 GAIN Summary Analytic Data Set (n=22,116)
General Satisfaction by Gender
35
100%
90%
12%
19%
80%
Low
Satisfaction
(0-2)
70%
60%
Moderate
Satisfaction
(3-4)
50%
40%
30%
High
Satisfaction
(5-6)
20%
10%
0%
Male
Female
SAMHSA 2011 GAIN Summary Analytic Data Set (n=12,277)
Program by Gender
36
100%
ATM
ART
CYT
YORP
ORP
ATDC
SCY
AAFT
DC
EAT
TCE
Other
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
Male
Female
SAMHSA 2011 GAIN Summary Analytic Data Set (n=29,771)
Level of Care by Gender
37
100%
90%
80%
9%
7%
13%
1%
7%
7%
1%
STR
13%
70%
M-LTR
60%
50%
CC-OP
40%
30%
70%
71%
IOP
20%
OP
10%
0%
Male
Female
SAMHSA 2011 GAIN Summary Analytic Data Set (n=29,738)
Type of Treatment by Gender
38
100%
6%
7%
90%
80%
Tx Man
17%
20%
70%
60%
Other
30%
24%
50%
40%
11%
10%
30%
20%
ACRA/ACC
Other EBTx
35%
40%
10%
MET/CBT
0%
Male
Female
SAMHSA 2011 GAIN Summary Analytic Data Set (n=28,869)
Outcomes
39

The following slides present information on the outcomes of
substance abuse treatment by gender, 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.
Percent Change in 6 Month Abstinence
by Gender
40
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
18%
Male
23%
Female
SAMHSA 2011 GAIN SA Data Set subset to 6 Month Follow up (n=20,173)
Relative Percent Change in 6 Month
Abstinence by Gender
41
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
52%
44%
Male
Female
SAMHSA 2011 GAIN SA Data Set subset to 6 Month Follow up (n=20,173)
Past Month AOD Abstinence by
Gender
42
100%
90%
80%
Male
70%
60%
50%
40%
30%
Female
20%
10%
0%
Intake
3 Month
6 Month
9 Month* 12 Month
SAMHSA 2011 GAIN SA Data Set subset to 1+ Follow ups
*Interpolated
Recovery* by Gender
43
100%
90%
80%
Male
70%
60%
50%
40%
30%
Female
20%
10%
0%
Intake
3 Month
6 Month
9 Month** 12 Month
* Recovery defined as no past month use, abuse, or dependence symptoms
while living in the community.
**Interpolated
SAMHSA 2011 GAIN SA Data Set subset to 1+ Follow ups
Change in GPRA Outcomes by
Gender (Intake to Last Wave*)
44
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
Vocationally
Engaged
Housing
No Justice
System
Involvement
No Social
Consequences
Male
Last
Wave
Intake
Intake
Last
Wave
Abstinence
Female
*Last wave is the last follow-up
SAMHSA 2011 GAIN SA Data Set subset to 1+ Follow ups
Socially
Connected
NOMS Outcome: Number of Treatment
Received Outcomes Met* by Gender
45
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
None
One
41%
40%
Two
Three
30%
30%
Male
Female
*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=24,610)
Four
SAMHSA Outcome: Treatment Cost
Bands by Gender
46
100%
90%
Above
80%
70%
60%
50%
Within
40%
30%
48%
47%
20%
Below
10%
0%
Male
Female
SAMHSA 2011 GAIN SA Data Set subset to 1+ Follow ups (n=17,847)
Change in Selected NOMS Outcomes by
Gender (Intake to Last Wave)
47
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
No Health
Problems
No Mental Health
Problems
No Family
Problems
Abstinence
Male
Last
Wave
Intake
Intake
Last
Wave
No Illegal
Activity
Female
SAMHSA 2011 GAIN SA Data Set subset to 1+ Follow ups
*Past month
Vocationally
Engaged*
Housed
NOMS Outcomes: Count of Positive
Outcomes (Last FU–Intake) by Gender
48
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
Less than
negative one
Negative one
None
One
Two
27%
31%
Three
Four
Male
(76% w/ 1+)
Female
(81% w/ 1+)
SAMHSA 2011 GAIN SA Data Set subset to 1+ Follow ups (n=25,498)
Five +