A randomized trial of treatment options for alcohol-abusing workers

Article Abstract:

Alcoholism and other forms of substance abuse constitute a significant health, social and economic problem. Employers and labor unions routinely refer workers with alcohol problems for treatment, yet little is known about how effective various treatments actually are. A large industrial plant with 10,000 workers provided an opportunity to compare the effectiveness of various treatment options. The plant maintained an employee-assistance program which helped workers who were found to have alcohol problems. For the purposes of this study, workers with newly discovered alcohol problems were randomly assigned into one of three experimental groups. One group was assigned to an inpatient program for alcohol abuse; another group began mandatory attendance at Alcoholics Anonymous (AA) meetings; the third group was permitted a choice of options - the assistance program provided information about options but did not provide advice on the choice. A total of 227 workers were assigned in this manner and followed-up over a two-year period. Data were collected on work performance and also on direct measures of drinking and drug abuse. These data indicated that there were improvements in all three groups. The three groups were comparable in job performance. However, some indicators of drinking and drug abuse revealed differences among the three treatment groups. Sixty-three percent of the workers enrolled in the AA program required additional inpatient treatment at some point, in contrast with only 38 percent of the workers enrolled in the inpatient program. The workers who chose a program had outcomes which were between these two extremes. The differences between the AA program and the inpatient program were even more striking among the workers who had abused cocaine in addition to alcohol. It should be pointed out that although the AA program was significantly cheaper than the inpatient program, the overall costs were not much different. The increased requirement for further treatment among the AA group resulted in a cost of AA treatment which was only about 10 percent less than the inpatient program. The results indicate that treatment in AA programs is riskier than inpatient programs and that workers treated in such programs should be watched closely for signs of relapse. (Consumer Summary produced by Reliance Medical Information, Inc.)

Care and treatment, Employee alcoholism, Alcoholism, Alcoholism treatment

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Differences in the use of psychiatric outpatient services between the United States and Ontario

Article Abstract:

The greatest use of mental health services in the US appears to occur among those least likely to need them. This was the conclusion of a study that compared the use of psychiatric outpatient services in the US and Ontario, Canada. In 1990, 13.3% of Americans surveyed had used psychiatric outpatient services, compared to 8% of Canadians. The percentage of Americans who had psychiatric problems was greater than in Ontario and Americans who were most likely to need services had mild to moderate mental illness.

Usage, Services, Mentally ill persons, Social policy, Psychiatric services, Mental health services, Mentally ill, Ontario

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Will parity in coverage result in better mental health care?

Article Abstract:

The Mental Health Equitable Treatment Act of 2001 may improve insurance coverage of mental disorders. The act is modeled on the parity provisions for mental health and substance abuse in the Federal Employees Health Benefits Program. In this context, parity means treating mental disorders and substance abuse as comprehensively as other diseases are treated.

Laws, regulations and rules, Mental illness, Mental disorders, Health insurance industry

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