Headline
A contingency management program in a community mental health clinic increased stimulant abstinence during and following treatment and reduced hospitalizations for psychiatric care.
Background
Community mental health centers are important treatment settings for people who have serious mental illness (SMI). These treatment settings also show promise for implementing evidence-based contingency management for treating substance use disorder, as about half of people with SMI experience a substance use disorder at some point in their lives. This study’s main objective was to evaluate whether adding contingency management to the treatment plans of individuals with SMI and co-occurring stimulant use disorder at community mental health centers was effective in reducing stimulant use. It also examined reductions in other drugs and alcohol, the severity of drug use, the severity of psychiatric symptoms, and other health-related behaviors.
Findings
The authors analyzed breath and urine samples for a 12-week treatment period and 12-week follow up period, while also tracking psychiatric hospitalizations, incarcerations, and mental health symptoms, between two randomly assigned groups — contingency management and control groups — where both received case management and group or individual treatment. Participants in the contingency management group were 2.4 times more likely to submit a stimulant-free urine sample during treatment and had 40% more substance-free samples following treatment. Individuals in this group also self-reported fewer days of stimulant and alcohol use during treatment and experienced fewer hospitalizations for psychiatric care.
Policy/Program Takeaways
Community mental health centers can play an important role in addressing both the mental health and substance use needs of people in their programs with SMI. Providers can use this study as an example of how contingency management was successfully implemented in the setting for this population.