Curran GM (HSR&D Center for Mental Healthcare and Outcomes Research)
Co-occurring substance use and depressive disorders are common, yet little is known about the experiences of persons with these comorbid disorders. This study seeks to document these experiences, with an emphasis on the process of seeking/receiving services for comorbidity.
Interviews with veterans with both substance use and depressive disorders are being conducted as part of the development phase of an implementation study to introduce evidence-based depression management in substance abuse treatment programs in the VA. This study, currently in data collection, will interview 30 persons with comorbid substance use and depressive disorders. All participants will be identified in substance abuse treatment programs and interviewed while in treatment. The interview is semi-structured, with a common core of questions concerning treatment-seeking for co-occurring disorders, receipt of treatment, experiences with antidepressant medication, medication adherence, and recommendations for treatment changes from the patient’s perspective.
Thirteen interviews have been completed thus far. Preliminary data indicate similarities of experience in several areas. Most notable, comorbid individuals in substance use treatment programs exhibit a considerable lack of understanding about their depressive disorder and seek more information about their condition, its causes, and treatments available. As well, while many have been on medication at some point, medication adherence was often reported as a barrier to treatment success. Thus far, a common recommendation offered for programs is more opportunities for “talk therapies” and group interactions with other persons with depression and substance use disorders.
Input from consumers is essential to maximize the sustainability of treatment interventions. Data from these interviews will be used to guide the development of the depression intervention and the implementation strategy used to assist in its implementation.
The study is in a development phase, so impacts at this time are few. However, we expect a substantial positive impact on care in the future as we produce a sustainable depression intervention and implementation strategy for substance abuse treatment in the VA.