Download - Chapter 5 Subset of Overview by Age
Chapter 5Subset of Overview by
Age
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
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
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
Age
18 -25 Years 13.4%
(n=3,976)
Under 15 Years (<15) 13.8%
(n=4,105)
15-17 Years 63.5%
(n=18,897)
26+ Years 9.4%
(n=2,804)
SAMHSA 2011 GAIN Summary Analytic Data Set (n=29,782)
4
Risk and Protective Factors by Age 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
Gender by Age
<15 15-17 18-25 26+0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
31%25% 28%
40%
69%75% 72%
60% Male
Female
SAMHSA 2011 GAIN Summary Analytic Data Set (n=29,771)
6
Race by Age
<15 15-17 18-25 26+0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
15% 16% 16% 17%
32% 28% 31% 28%
4%4% 3% 3%
32% 38% 38% 45%
16% 14% 11% 7%
Multi-Racial
White
Other
Hispanic
African American
SAMHSA 2011 GAIN Summary Analytic Data Set (n=29,767)
7
Risk of Homelessness by Age
<15 15-17 18-25 26+0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
84% 79%64%
47%
2% 3% 8% 13%
Currently Homeless
At Risk of Homeless-ness
Group/Inst
Housed
SAMHSA 2011 GAIN Summary Analytic Data Set (n=29,646)
8
Past Year Substance Severity by Age
<15 15-17 18-25 26+0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
41%49% 51% 48%
PY De-pendence
PY Abuse
PY Use
No PY Use
SAMHSA 2011 GAIN Summary Analytic Data Set (n=29,358)
9
Primary Substance by Age
<15 15-17 18-25 26+0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
24% 25% 30% 33%
65% 63%40%
9%
Other Drug
Opioids
Amphetamines
Cocaine
Marijuana
Alcohol
SAMHSA 2011 GAIN Summary Analytic Data Set (n=27,716)
10
<15 15-17 18-25 26+0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%13%
23%30% 26%
High SU (6-8)
Moderate SU (3-5)
Low SU (0-2)
Number of Substance Problems by Age
SAMHSA 2011 GAIN Summary Analytic Data Set (n=27,716)
11
Tobacco Diagnosis by Age
<15 15-17 18-25 26+0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
26%37%
49% 51%
Dependence/Daily Use
Current PY Use
Past Use
Never Used
SAMHSA 2011 GAIN Summary Analytic Data Set (n=27,384)
12
HIV Risk Scale* by Age
* Available at intake only.
<15 15-17 18-25 26+0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%12%
19%28% 31% High
Risk(10-36)
Moderate Risk(3-9)
Low Risk(0-2)
SAMHSA 2011 GAIN Summary Analytic Data Set (n=29,746)
13
HIV Risk Change Index* by Age
*Can be used to measure change.
<15 15-17 18-25 26+0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%7% 9% 11% 6%
HighRisk(4-7)
ModerateRisk(2-3)
LowRisk(0-1)
SAMHSA 2011 GAIN Summary Analytic Data Set (n=26,835)
14
Number of Sex Partners* by Age
<15 15-17 18-25 26+0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%13% 17% 16%
6%
3+ Sex Partners
1-2 Sex Partners
No Sex Partners
*In the past 90 days
SAMHSA 2011 GAIN Summary Analytic Data Set (n=28,751)
15
Severity of Victimization by Age
<15 15-17 18-25 26+0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
39% 44%53% 59%
High Severity (4-15)
Moderate Severity (1-3)
Low Severity (0)
SAMHSA 2011 GAIN Summary Analytic Data Set (n=29,501)
16
Mental Health Disorders by Age
<15 15-17 18-25 26+0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
33% 34% 31% 26% Both
Internalizing Disorders Only
Externalizing Disorders Only
Neither
SAMHSA 2011 GAIN Summary Analytic Data Set (n=29,684)
17
Homicidal/Suicidal Thoughts by Age
<15 15-17 18-25 26+0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100% 3% 3%2% 3%
#REF!
#REF!
#REF!
SAMHSA 2011 GAIN Summary Analytic Data Set (n=29,469)
18
Health Problems by Age
<15 15-17 18-25 26+0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%7% 8% 10%
17%High Prob-lems(33-100)
Moderate Problems (10-32)
Low Prob-lems(0-9)
SAMHSA 2011 GAIN Summary Analytic Data Set (n=29,477)
19
<15 15-17 18-25 26+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
$2,499 $2,451$2,663
$2,851
$7,600+
$1 - $7,599
$0
Mean
Health Care Utilization Cost* by Age
*Using 2011 Dollars
SAMHSA 2011 GAIN Summary Analytic Data Set (n=28,481)
20
Crime & Violence by Age
<15 15-17 18-25 26+0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
42% 39%26%
9%
High Crime(7-29)
Moderate Crime (3-6)
Low Crime(0-2)
SAMHSA 2011 GAIN Summary Analytic Data Set (n=29,703)
21
Type of Crime by Age
<15 15-17 18-25 26+0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
45% 43%
27%
9%
Violent Crime*
Other Crime**
Drug Use only
SAMHSA 2011 GAIN Summary Analytic Data Set (n=29,377)
* Violent crime includes assault, rape, murder, and arson.** Other crime includes vandalism, possession of stolen goods, forgery, and theft.
22
Cost of Crime* by Age
*Using 2011 Dollars
SAMHSA 2011 GAIN Summary Analytic Data Set (n=27,405)
<15 15-17 18-25 26+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
$822,000
$569,572
$370,986
$45,668
$120,000+
$1-$119,000
$0
Mean
23
<15 15-17 18-25 26+0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%Detention/jail 30+ days
Detention/jail 14-29 days
Drug Court
Prob/parole 14+ days w/ 1+ drug screens
Other probation, parole, detention
Other JJ/CJ status
Past arrest/JJ/CJ sta-tus
Past yr illegal activity/SA use
Intensity of Justice System Involvement by Age
SAMHSA 2011 GAIN Summary Analytic Data Set (n=29,617)
24
Count of Major Clinical Problems* at Intake by Age
<15 15-17 18-25 26+0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
45% 48% 46% 42%
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
SAMHSA 2011 GAIN Summary Analytic Data Set (n=29,782)
25
Sources of Stress Index by Age
<15 15-17 18-25 26+0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
34% 32%40%
50%
High Stress(3-15)
Moderate Stress(1-2)
Low Stress(0)
SAMHSA 2011 GAIN Summary Analytic Data Set (n=12,592)
26
Treatment Readiness by Age
<15 15-17 18-25 26+0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100% 5% 6% 4% 1%
Low Readiness (0-2)
ModerateReadiness (3-5)
High Readiness (6-9)
SAMHSA 2011 GAIN Summary Analytic Data Set (n=28,344)
27
Self-Help Activities by Age
<15 15-17 18-25 26+0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
94% 87%
68%
51%
Low Activity(0)
Moderate Activity(1-11)
High Activ-ity(12-19)
SAMHSA 2011 GAIN Summary Analytic Data Set (n=8,342)
28
Strength Self-Efficacy Index by Age
<15 15-17 18-25 26+0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%10% 8% 6% 8%
Low Strength(0-2)
Moderate Strength (3-6)
High Strength (7-10)
SAMHSA 2011 GAIN Summary Analytic Data Set (n=12,766)
29
General Social Support Index by Age
<15 15-17 18-25 26+0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100% 6% 5% 7% 10%
Low Support(0-1)
Moderate Support (2-4)
High Support(5-9)
SAMHSA 2011 GAIN Summary Analytic Data Set (n=14,717)
30
Spiritual Social Support by Age
<15 15-17 18-25 26+0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
62% 57%48%
28% Low Support (0-2)
Moderate Support (3-5)
High Support (6-7)
SAMHSA 2011 GAIN Summary Analytic Data Set (n=12,476)
31
Environmental Strengths Index by Age
<15 15-17 18-25 26+0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100% 5% 6% 11% 16%Low Strength(0-2)
Moderate Strength (3-5)
High Strength(12-16)
SAMHSA 2011 GAIN Summary Analytic Data Set (n=27,625)
32
<15 15-17 18-25 26+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
$4,337 $4,725
$5,341
$6,525
$10,000+
$2,000 - $9,999
$0-$1,999
Mean
Quarterly Cost to Society* by Age
*Using 2011 Dollars
SAMHSA 2011 GAIN Summary Analytic Data Set (n=26,690)
33
Problem Prevalence Index by Age
<15 15-17 18-25 26+0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100% 6% 7% 10% 8%
High Preva-lence(25-100)
Moderate Prevalence (6-24)
Low Preva-lence(0-5)
SAMHSA 2011 GAIN Summary Analytic Data Set (n=27,605)
34
Quality of Life by Age
<15 15-17 18-25 26+0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
35% 37%25%
17%Low Quality (0-36)
Moderate Quality (37-69)
High Quality(70-100)
SAMHSA 2011 GAIN Summary Analytic Data Set (n=22,126)
35
General Satisfaction by Age
<15 15-17 18-25 26+0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%11% 10% 16%
26% Low Satis-faction(0-2)
Moderate Satisfaction(3-4)
High Satis-faction(5-6)
SAMHSA 2011 GAIN Summary Analytic Data Set (n=12,281)
36
Program by Age
<15 15-17 18-25 26+0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%ATM
ART
CYT
YORP
ORP
ATDC
SCY
AAFT
DC
EAT
TCE
Other
SAMHSA 2011 GAIN Summary Analytic Data Set (n=29,782)
37
Level of Care by Age
<15 15-17 18-25 26+0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
77% 71% 71%
54%
10%11% 11%
37%
4% 8% 10%4%9% 9% 8% 5%1% 2%
STR
M-LTR
CC-OP
IOP
OP
SAMHSA 2011 GAIN Summary Analytic Data Set (n=29,749)
38
Type of Treatment by Age
<15 15-17 18-25 26+0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
47% 41%
24%14%
13%9%
11%20%
27%31%
37%
9%11% 24%
66%
5% 8% 4%
Tx Man
Other
ACRA/ACC
Other EBTx
MET/CBT
SAMHSA 2011 GAIN Summary Analytic Data Set (n=28,880)
39
Outcomes The following slides present information on the outcomes of
substance abuse treatment by age, 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.
40
Percent Change in 6 Month Abstinence by Age
<15 15-17 18-25 26+0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
25% 20%15% 15%
SAMHSA 2011 GAIN SA Data Set subset to 6 Month Follow up (n=20,181)
41
Relative Percent Change in 6 Month Abstinence by Age
<15 15-17 18-25 26+0%
10%20%30%40%50%60%70%80%90%
100%
62%51%
32%24%
SAMHSA 2011 GAIN SA Data Set subset to 6 Month Follow up (n=20,181)
42
Past Month AOD Abstinence by Age
Intake 3 Month 6 Month 9 Month* 12 Month0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
<15
15-17
18-25
26+
*InterpolatedSAMHSA 2011 GAIN SA Data Set subset to 1+ Follow ups
43
Recovery* by Age
Intake 3 Month 6 Month 9 Month** 12 Month0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
<15
15-17
18-25
26+
* 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
44In
take
Las
t W
ave
Inta
ke
Las
t W
ave
Inta
ke
Las
t W
ave
Inta
ke
Las
t W
ave
0%10%20%30%40%50%60%70%80%90%
100%
Vocationally Engaged
Housing
No Justice Sys-tem Involvement
No Social Consequences
Abstinence
Socially Connected
Change in GPRA Outcomes by Age (Intake to Last Wave*)
<15 15-17 18-25 26+
*Last wave is the last follow-up
SAMHSA 2011 GAIN SA Data Set subset to 1+ Follow ups
45
NOMS Outcome: Number of Treatment Received Outcomes Met* by Age
<15 15-17 18-25 26+0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
33% 31% 35%
11%
39% 40% 39%
47%
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=24,620)
46
SAMHSA Outcome: Treatment Cost Bands by Age
<15 15-17 18-25 26+0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
55% 50%38%
28%
Above
Within
Below
SAMHSA 2011 GAIN SA Data Set subset to 1+ Follow ups (n=17,856)
47
Change in Selected NOMS Outcomes by Age (Intake to Last Wave)
Inta
ke
Las
t...
Inta
ke
Las
t...
Inta
ke
Las
t...
Inta
ke
Las
t...
0%
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
<15 15-17 18-25 26+*Past monthSAMHSA 2011 GAIN SA Data Set subset to 1+ Follow ups
48
NOMS Outcomes: Count of Positive Outcomes (Last FU–Intake) by Age
< 15 (77% w/ 1+)
15-17 (77% w/ 1+)
18-25 (78% w/ 1+)
26+ (76% w/ 1+)
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
27% 29% 28% 22%
Less than nega-tive one
Negative one
None
One
Two
Three
Four
Five +
SAMHSA 2011 GAIN SA Data Set subset to 1+ Follow ups (n=25,508)