Institute of Psychiatric Research, Department of Psychiatry, Indiana University School of Medicine, 791 Union Dr., Indianapolis, IN 46202, USA.
Psychiatr Serv. 2010 Feb;61(2):184-8. doi: 10.1176/ps.2010.61.2.184.
Inadequate physician training and involvement in addictions treatment are barriers to integrating mental health and addiction services in public behavioral health care. The authors designed and implemented the Dual Diagnosis Physician-infrastructure Assessment Tool (DDPAT) to quantify statewide dimensions of this workforce problem.
The DDPAT examined institutional dual diagnosis capability and physician workforce, training backgrounds, and clinical roles across Indiana's 30 community mental health centers (CMHCs), six psychiatric hospitals, and 13 addiction treatment centers.
All treatment centers and 75% of physicians responded. Sixty-nine percent of all treatment centers and 97% of CMHCs reported dual diagnosis capability. However, 29% of physicians treated both mental illness and addictions, and only 8% had certification in an addiction specialty. Overall workforce shortages, particularly of younger psychiatrists, contextualized these findings.
The DDPAT identified multiple deficiencies in the physician workforce with respect to dual diagnosis and addictions care in Indiana. The DDPAT may be useful for characterizing similar trends in other states.
医生培训和参与不足是将精神健康和成瘾服务融入公共行为健康护理的障碍。作者设计并实施了双重诊断医生基础设施评估工具 (DDPAT)，以量化全州范围内该劳动力问题的各个方面。
DDPAT 调查了印第安纳州 30 个社区心理健康中心、6 家精神病医院和 13 家成瘾治疗中心的机构双重诊断能力和医生劳动力、培训背景和临床角色。
所有治疗中心和 75%的医生都做出了回应。69%的所有治疗中心和 97%的社区心理健康中心报告了双重诊断能力。然而，只有 29%的医生同时治疗精神疾病和成瘾，只有 8%的医生拥有成瘾专业认证。整体劳动力短缺，尤其是年轻的精神科医生短缺，使得这些发现具有背景意义。
DDPAT 确定了印第安纳州医生劳动力在双重诊断和成瘾治疗方面存在多项不足。DDPAT 可能对其他州类似趋势的描述有用。
