Who seeks care where? Utilization of mental health and substance use disorder treatment in two national samples of individuals with alcohol use disorders

Abstract

Objective: Only a fraction of individuals with alcohol use disorders (AUDs) receive any AUD treatment during a given year. If a substantial proportion of individuals with unmet need for AUD treatment are receiving mental health treatment, accessibility of AUD treatment could potentially be improved by implementing strategies to ensure that individuals receiving mental health care are referred to the AUD sector or by increasing rates of AUD treatment in individuals receiving mental health treatment. Method: We assessed patterns and predictors of mental health treatment and AUD treatment among individuals with 12-month AUDs, using secondary data analyses from two national surveys, the National Survey on Drug Use and Health (NSDUH; n = 4,545 individuals with AUDs) and the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC; n = 3,327 individuals with AUDs). Results: In both NSDUH and NESARC, 8% of individuals with AUDs reported past-year AUD treatment. Among individuals with AUDs, mental health treatment was more common than AUD treatment, with 20% of NSDUH respondents and 11% of NESARC respondents reporting receiving mental health treatment. Greater mental health morbidity increased the odds of mental health treatment, and AUD severity increased the odds of AUD treatment. Mental health morbidity also increased the odds of AUD treatment, mainly by increasing the odds of receiving the category of both AUD and mental health treatment. Conclusions: Because individuals with AUDs are more likely to receive mental health treatment than AUD treatment, a key opportunity to improve the overall accessibility of treatment for AUDs may be to focus on improving AUD treatment among individuals receiving mental health treatment. (J. Stud. Alcohol Drugs, 73, 635-646, 2012)