DESCRIPTION OF FOLLOW-UP SAMPLE AT INTAKE SECTION TWO

Transcription

1 SECTION TWO DESCRIPTION OF FOLLOW-UP SAMPLE AT INTAKE 7

2 2.1 DEMOGRAPHIC CHARACTERISTICS Table 2.1 presents demographic descriptive data at intake for those who were included in the follow-up study. Data include frequencies and means for gender, age, ethnic background, marital status, living arrangements, and dependents. The follow-up sample was mostly male (65.3%) with a mean age of 34 at intake. It was also predominately Caucasian (87.2%), with a smaller portion of Black individuals (11.1%), and only 0.9% reporting a Hispanic background. Over one-third of the clients (38.7%) had never been married at intake. Also the majority of clients were housed (91.1%) rather than institutionalized or homeless. At intake, just over 1 in 3 clients, reported living with dependent children. Table 2.1. Demographic Characteristics of Follow-Up Sample at Intake Intake question Breakdown n=1,056 Demographics Gender Male 65.3% Mean age 34.0 Race 1 White Black Native Am. Asian Other 87.2% 11.1% 1.0% 0.2% 0.5% Ethnicity: 0.9% Hispanic / Latino 2 Marital status Current living arrangements Never married Married Divorced Separated Widowed Housed Institutionalized Shelter Street/Outdoors 38.7% 23.6% 26.7% 9.5% 1.4% 91.1% 7.2% 1.2% 0.5% Percent of sample who live Dependent child(ren) 34.0% with: Anyone with an alcohol problem 7.7% Anyone with a drug problem 7.3% 1 Percents do not add to 100 since clients can identify more than one race 2 Current GPRA measures ask ethnicity as a separate question. 8

3 2.2 EDUCATION, EMPLOYMENT, AND ECONOMIC STATUS Table 2.2 presents a description of the sample s education history, employment and economic status at intake. The mean education level was slightly higher than 11 th grade, although 43.8% reported having less than 12 years of education. Of those clients with less than 12 years of education, 36.7% reported having earned a GED. About half (44.5%) of the follow-up sample was either employed or enrolled in school/job training at least part-time at intake. About 14.1% of the sample reported disability, and 37.9% reported being unemployed (although 6.2% of these individuals were enrolled in school/job training part or full-time). The mean number of days of paid work in the past 30 days for the entire sample was about 13. However, the mean number of paid work days in the past 30 days for the employed (part and full time) and job training clients was about 17 days. Table 2.2. Education, Employment and Economic Status at Intake Intake question Options n=1,056 Education and employment Mean education (in years) 11.4 years Less than 12 years education 43.8% GED (among those with less 36.7% than 12 years education) Enrollment status for school or job training Not enrolled Full time Part time Other 91.9% 4.3% 1.9% 2.0% Employment Income Mean # days paid for working for those who work Received income from: Mean monthly income for those receiving the following type of income: Full time Part time Retired Disabled Unemployed, looking Unemployed, volunteer Other 31.1% 7.2% 1.2% 14.1% 37.9% 0.7% 7.7% 17.1 Wages 42.3% Public assistance 6.9% Retirement 1.1% Disability 11.6% Illegal source 0.5% Other 11.0% Wages $1041 Public assistance $325 Retirement $880 Disability $649 Illegal $1430 Other $599 9

4 2.3 PHYSICAL AND MENTAL HEALTH Table 2.3 presents self-report descriptions of physical and mental health factors at intake. Almost one-third of the clients (30.6%) reported a lifetime experience of physical abuse victimization, and sexual abuse victimization was reported by 18.7% of clients. More than half of all participants reported experiencing serious depression, anxiety, or both (not a direct result of alcohol or drug use) during the 12 months preceding intake (not presented in table). Almost one-third (31.3%) of clients reported being treated with psychiatric medications in the past 12 months. On average, clients reported being considerably troubled by emotional problems during the past year. Despite the extent of mental health issues reported, the mean current physical health rating (2.9) suggested that clients, on average, were experiencing good to very good overall health at the time of intake. However, 28.2% of clients reported fair or poor health at intake. Table 2.3. Percent of Clients Reporting Past 12 Month Physical & Mental Health Factors at Intake Intake question Responses n=1,056 Lifetime Abuse experience Abuse history Physical assault 30.6% Sexual assault 18.7% Past 12 months Mental health problem Psychological problems not Serious depression 42.0% directly a result of alcohol or Serious anxiety 46.7% drug use Serious depression & serious anxiety 35.8% Hallucinations 6.8% Trouble remembering/concentrating 38.9% Trouble controlling violent behavior 14.8% Past 12 months Suicide Suicide history Suicidal thoughts 13.7% Suicide attempts 5.4% Past 12 months Medication Prescribed psychiatric meds 31.3% Mean of how troubled by (0- Not at all to 4- Extremely scale) 2.5 emotional problems Intake Health rating Overall current health rating 1. Excellent 2. Very good 3. Good 4. Fair 5. Poor 10.4% 24.6% 36.8% 20.4% 7.8% Mean rating of current health (1-5 scale)

5 2.4 JUSTICE SYSTEM INVOLVEMENT Table 2.4a presents admission referral and legal status of clients at the time of intake. About two-thirds of participants (64.0%) were referred to treatment by the justice system and over one-third (33.5%) of the follow-up clients were referred to treatment from a DUI charge. At intake, 33.2% were on probation or parole, while 7.6% were in Drug Court. In Table 2.4b, arrest data are presented for all charges, specifically drug-related charges, and drug arrests for DUI. The percent of individuals reporting arrests, and the mean number for those reporting arrests, are presented. A little over 60% of clients were arrested at least once during the 12 months before intake, and 12.8% were arrested at least once in the 30 days before intake. Of those clients reporting arrests in the past 12 months, 41.0% had drug-related charges. Moreover, among those reporting arrests in the past 30 days, 37.8% had drug-related charges. Table 2.4b also presents incarceration time for those arrested. For those arrested during the 12 months before treatment, the mean number of nights in jail was 30.6 and for those arrested in the 30 days before treatment, the mean was 2.4 nights. Table 2.4a. Referral Circumstance and Legal Status at Intake Intake question Options n=1,056 Admission/referral Percent of sample referred by criminal justice system a 64.0% reasons Percent of overall sample referred following DUI charge 33.5% Current legal status In Drug Court 7.6% On probation/parole 33.2% a Those admitted due to a DUI were also included as criminal justice referrals Table 2.4b. Arrest and Incarceration History at Intake Intake question Options Past 12 months Past 30 days Arrests Any charge % of sample arrested on any charge 60.3% 12.8% Mean # arrests for those arrested Any drug arrest % of sample arrested on drug charge 24.7% 4.8% Mean # for those arrested on drug charge Drug arrests % of sample of all those with any arrests 41.0% 37.8% whose arrests were for drug charges Jail time Entire sample % of total sample spending at least % 19.2% night in jail (including those with no arrests) Mean number nights in jail (including those with no arrests) Those arrested 12 Months (n = 637) 30 Days (n = 135) % spending at least 1 night in jail Mean number nights in jail 90.0% %

6 2.5 TREATMENT HISTORY Table 2.5 presents follow-up clients self-reported substance abuse treatment history at intake. Almost two-thirds of clients (66.0%) reported a history of substance abuse treatment prior to this intake, and those previously treated had an average of 2.4 treatment episodes. In addition to formal treatment, over half the clients at intake (60.2%) reported having participated in Alcoholics Anonymous (AA), Narcotics Anonymous (NA), and other self-help groups, and over one-third (32.5%) reported attending AA/NA in the past 30 days. Significantly more women than men (39.9% versus 28.6%) reported attending self-help groups during the past 30 days. Of the people who attended self-help groups, almost one-half (45.6%) reported that the meetings were always helpful and almost one-third (31.0%) reported self-help groups were often helpful. Table 2.5. Treatment History at Intake Intake question Options n=1,056 Any substance abuse Percent reporting ever having been in treatment before 66.0% treatment in lifetime Mean# of times treated for those reporting prior treatment 2.4 AA, NA, or other Selfhelp group Gender and use of Selfhelp group in past 30 days How often were these meetings helpful (n = 342) Percent of sample who have tried self-help in lifetime 60.2% Percent of sample who have tried self-help in past 30 days 32.5% For all those who have tried in lifetime, mean # times 5.7 attended during the past 30 days Percent of women 39.9%** Percent of men 28.6% 0. Never 1. Rarely 2. Sometimes 3. Often 4. Always 2.0% 3.5% 17.8% 31.0% 45.6% Mean rating of helpfulness (0-4 scale) 3.2 **p < SUBSTANCE USE AT INTAKE Figure 2.6a describes the percent of clients reporting substance use at intake for the 12 months and 30 days preceding intake. Alcohol use is reported by most clients with 77.6% of all clients reporting alcohol use within the past 12 months and 43.6% reporting use in the past 30 days at intake. Alcohol use to intoxication in the past 12 months was reported by 64.0% of clients and by 31.9% of clients in the past 30 days. The past 12 months use of marijuana was reported by 49.1% of clients and tranquilizer use was reported by 34.7% of the clients. Opiate use in the past 12 months was reported by 31.3%, a slightly larger percent of clients reporting use of this drug than past 12 months cocaine use, which was reported by 29.4% of clients. Past 12 month stimulant use was reported by 17.0% of clients and nonprescription methadone was reported by 8.4%. Hallucinogens and inhalants were used by very few individuals with only 5.2% reporting hallucinogens and 2.2% reporting inhalant use. 12

7 Figure 2.6a. Percent of Clients Reporting Substance Use in the Past 12 Months and Past 30 Days at Intake (n=1,056) Past 30 days Past 12 months Alcohol Alcohol to intoxication Marijuana Tranquilizers Opiates Cocaine Stimulants Nonprescription methadone Hallucinogens Inhalants 43.6% 31.9% 49.1% 24.3% 34.7% 19.7% 31.3% 17.2% 29.4% 13.8% 17% 6.2% 8.4% 3.5% 5.2% 0.9% 2.2% 0.5% 64% 77.6% Figure 2.6b presents the proportion of days that clients reported using substances at intake, controlling for their time in controlled living environments. In other words, this figure shows the percent of time on the street that clients reported using substances. The figure presents the average days of use for the entire sample and for those clients who reported at least one day of substance use for each substance. For example, in examining the proportion of days of use among the entire sample, alcohol was used 14.3% of the days in the past 30 days, or approximately 4.2 days. However, when examining the average days of use for just those clients who reported at least one day of alcohol use in the past 30 days, the proportion of days of use was 33.7% of days, or approximately 9.6 days. Apart from alcohol, the drug with the greatest number of days of use at intake was tranquilizers, which were reported at 9.1% of the past 30 days (approximately 3.3 days) for the entire sample, and at 48.8% of the past 30 days (approximately 13.4 days) for those who reported at least one day of use. Excluding inhalant use, which was reported by very few clients, the two drugs with the greatest number of days of use among those who reported at least one day of use were opiates and tranquilizers. 13

8 Figure 2.6b. Average Percent Days of Substance Use in the Past 30 Days at Intake (n=1,056) Entire Sample Among clients who used for at least 1 day Alcohol Alcohol to intoxication Marijuana Tranquilizers Opiates Cocaine Stimulants Nonprescription methadone Hallucinogens Inhalants 14.3% 10.6% 8.4% 9.1% 9.3% 4.7% 2.1% 20.8% 0.7% 0.4% 16.3% 0.1% 33.7% 34.4% 36.2% 48.8% 55.1% 33.4% 35.4% 43.3% SUMMARY OF INTAKE CHARACTERISTICS OF FOLLOW-UP SAMPLE The follow-up sample included 1,056 clients, with the majority being white males, and having an average age of about 34 years. The mean education level of clients was eleventh grade; however, a large number of clients without a high school diploma reported obtaining a GED (36.7%). They also reported low levels of employment with only 31.1% reporting full-time work and almost half of clients (53.9%) reporting not being in involved in the work force (i.e., unemployed, disabled, retired). Of the follow-up sample clients, two-thirds (66.0%) reported having prior treatment experiences with an average 2.4 prior treatment episodes. A large number of clients (60.2%) reported having tried self-help groups with 32.5% having used self-help groups in the 30 days prior to intake. The characteristics of the sample at intake suggest serious substance use and mental health problems. Low employment and a high percent of justice system involvement also suggest the severity of problems related to substance use. Substance use data show that at intake 77.6% of clients reported alcohol use in the past 12 months, 49.1% reported use of marijuana, 34.7% reported tranquilizer use and 31.3% reported opiate use. The changes from intake to follow-up are described in the section three of this report. 14

9 2.8 COMPARISON OF FOLLOW-UP SAMPLE WITH THOSE NOT FOLLOWED UP While 4,100 clients consented at baseline to participate in the follow-up study, only 1,056 were sampled for the follow-up interviews. Table 2.8a compares baseline characteristics of clients who were included in the follow-up interviews with consenting clients who were not contacted. The follow-up sample differed significantly from those who were not contacted in several ways, including employment, criminal justice history, and drug use(see Table 2.8a, 2.8b, and 2.8c, and Figures 2.8a and 2.8b). The follow-up sample had fewer Black clients (11.3% versus 17.9%) when compared to the non-follow-up consenting group. Clients included in the follow-up sample also had a higher mean education level (11.4 years versus 11.1 years) and were significantly more likely to report being employed full-time (34.5% versus 27.2% for the non-follow-up group). Table 2.8a. General Descriptives of Follow-up vs. Non-follow-up Clients at Intake Demographic Follow-up (n = 1,056) No Follow-up (n = 3,044) Total (n = 4,100) Gender Male 65.3% 66.2% 66.0% Age M = 34.0 M = 33.4 M =33.7 Ethnic ** Black White 11.3% 88.7% 17.9% 82.1% 16.2% 83.8% Education (in years) Enrolled in School or Training 6.2% 6.5% 6.4% Enrollment status for school or job training Not enrolled Full time Part time Other 91.9% 4.3% 1.9% 2.0% 92.4% 4.1% 2.3% 1.2% 92.2% 4.2% 2.2% 1.4% Employed ** 45.3% 37.3% 39.3% Employment Status ** Full-time Part-time Unemployed(Looking) Disabled 34.5% 8.0% 41.9% 15.6% 27.2% 9.1% 48.0% 15.7% 29.1% 8.8% 46.4% 15.7% Wages in past 30 days $ $ $ Significance established using t- test; *p <.01. **p <

10 There were no significant differences in physical or mental health between consenting clients who participated in the follow-up study, and those who did not (see Table 2.8b.). Table 2.8b. Mental Health Descriptives of Follow-up vs. Non-follow-up Clients at Intake Demographic Overall Health (1 = Excellent to 5= Poor) Follow-up (n = 1,056) No Follow-up (n = 3,044) Total (n = 4,100) M = 2.91 M = 2.95 M = 2.93 Serious Depression 42.0% 44.6% 43.9% Serious Anxiety 46.7% 47.5% 47.3% Hallucinations 6.8% 6.6% 6.6% Trouble Concentrating 38.9% 40.4% 40.0% Trouble Controlling Violent 14.8% 16.9% 16.4% Behavior Suicide Thoughts 13.7% 14.8% 14.5% Attempted Suicide 5.4% 6.4% 6.1% Prescribed Meds for Emotional 31.3% 28.5% 29.2% Problems Troubled by emotional problems M = 2.44 M = 2.34 M = 2.28 (0 = Not at all to 4 = Extremely) Ever Been Physically Abused 30.6% 33.9% 33.0% Ever Been Sexually Abused 18.7% 19.0% 18.9% Significance established using t- test; *p <.01. **p <.001 Non-follow-up participants reported more arrests in both the past 30 days and the past 12 months when compared to clients included in the follow-up. Clients who were not followed up, also reported significantly more nights of incarceration at both 12 months and 30 days when compared to clients included in the follow-up (see Table 2.8c.). Clients not followed up were also significantly more likely to be on probation or parole with 38.0% of those not followed-up clients reporting probation or parole status, compared to 33.2% of the follow-up sample. 16

11 Table 2.8c.Involvement with the Criminal Justice System of Follow-up vs. Nonfollow-up Clients at Intake Demographic Follow-up (n = 1,056) No Follow-up (n = 3,044) Total (n = 4,100) Referred by Criminal Justice System 64.0% 59.9% 61.0% Admission a Result of DUI ** 33.5% 23.0% 25.7% # of Arrests Past 30 Days ** # of Arrests Past 12 Months ** # of Arrests for Drugs Past 30 Days ** # of Arrests for Drugs Past 12 Months # of DUIs Past 30 Days # of DUIs Past 12 Months # of Nights in Jail Past 30 Days ** # of Nights in Jail Past 12 Months ** Currently in Drug Court 7.6% 9.2% 8.8% Currently on Probation/Parole * 33.2% 38.0% 36.8% Significance established using t- test; *p <.01. **p <.001 While there were only slight substance use differences between the two groups, clients who were not included in the follow-up study were more likely to report marijuana, cocaine, and stimulant use in the past 30 days (see Figures 2.8a and 2.8b). Clients who did not participate in the follow-up study also reported more cocaine use in the past 12 months. 17

12 Figure 2.8a. Percent of Clients Reporting Substance Use in the Past 30 Days-- Followup vs. Non-follow-up Clients at Intake No follow-up Follow-up Alcohol Alcohol to intoxication 32% 35.9% 43.6% 46.3% Marijuana ** 24.4% 30.9% Tranquilizers Cocaine ** 13.8% 19.7% 22.1% 23.6% Stimulants * 6.2% 8.6% Nonprescription methadone 3.5% 4.6% Inhalants 0.5% 0.8% *p <.01, ** p <.001 Controls for time in controlled environment Figure 2.8b. Percent of Clients Reporting Substance Use in the Past 12 Months-- Follow-up vs. Non-follow-up Clients at Intake No follow-up Follow-up Alcohol Alcohol to intoxication Marijuana Tranquilizers 34.7% 35.6% 64.1% 62.9% 49.2% 53.4% 77.7% 75.8% Cocaine ** 29.4% 38.8% Stimulants Nonprescription methadone Inhalants 8.4% 9.1% 2.2% 2.1% 17.1% 19.9% *p <.01, ** p <.001 Controls for time in controlled environment 18