Silver School of Social Work, New York University, New York City (Y. Hu, Baslock, Stanhope); College of Social Work, Ohio State University, Columbus (R. Hu).
Psychiatr Serv. 2024 Dec 1;75(12):1192-1198. doi: 10.1176/appi.ps.20230477. Epub 2024 Jul 10.
Certified community behavioral health clinics (CCBHCs) are designed to provide comprehensive care for individuals with co-occurring mental and substance use disorders. The authors classified outpatient mental health treatment facilities on the basis of provision of services for clients with co-occurring disorders and assessed whether CCBHCs differed from other outpatient mental health facilities in services provided.
The authors used latent class analysis to identify distinct services for clients with co-occurring disorders in 5,692 outpatient mental health facilities in the 2021 National Substance Use and Mental Health Services Survey. Nine indicators were included: treatment for clients with substance or alcohol use disorder co-occurring with serious mental illness or serious emotional disturbance, specialized programs or groups for such clients, medication-assisted treatment (MAT) for alcohol use disorder, MAT for opioid use disorder, detoxification, individual counseling, group counseling, case management, and 12-step groups. A multinomial logistic regression was used to estimate whether CCBHCs were associated with any identified classes after analyses controlled for facility characteristics.
A four-class solution provided a model with the best fit, comprising comprehensive services (23.4%), case management services (17.7%), counseling and self-help services (58.6%), and professional services (4.3%). Regressing class membership on facility type and covariates, the authors found that compared with community mental health clinics (CMHCs), CCBHCs were more likely to belong to the comprehensive services class than to the case management services, counseling and self-help services, and professional services classes.
CCBHCs were more likely than other outpatient programs to offer comprehensive care, and CCBHC status of a CMHC facilitated enhanced service provisions.
认证的社区行为健康诊所（CCBHC）旨在为同时患有精神和物质使用障碍的个人提供综合护理。作者根据为同时患有障碍的客户提供的服务对门诊心理健康治疗设施进行分类，并评估 CCBHC 与其他门诊心理健康设施在提供的服务方面是否存在差异。
作者使用潜在类别分析，在 2021 年国家物质使用和心理健康服务调查中的 5692 家门诊心理健康治疗设施中确定了同时患有物质或酒精使用障碍和严重精神疾病或严重情绪障碍的客户的不同服务。纳入了九个指标：为同时患有物质或酒精使用障碍和严重精神疾病或严重情绪障碍的客户提供的治疗、为这些客户提供的专门计划或小组、酒精使用障碍的药物辅助治疗 (MAT)、阿片类药物使用障碍的 MAT、解毒、个体咨询、小组咨询、个案管理和 12 步小组。在控制设施特征的分析后，使用多项逻辑回归估计 CCBHC 是否与任何确定的类别相关。
四分类解决方案提供了一个最佳拟合的模型，包括综合服务（23.4%）、个案管理服务（17.7%）、咨询和自助服务（58.6%）和专业服务（4.3%）。将类别成员资格回归到设施类型和协变量，作者发现与社区心理健康诊所（CMHC）相比，CCBHC 更有可能属于综合服务类别，而不是个案管理服务、咨询和自助服务以及专业服务类别。
CCBHC 比其他门诊计划更有可能提供综合护理，而 CMHC 的 CCBHC 地位促进了服务的加强。
