The National Survey of Substance Abuse Treatment Services
(N-SSATS) is an annual survey of all facilities in the United States,
both public and private, that provide substance abuse treatment. In 2000,
the 13,428 facilities responding to the N-SSATS
were asked about the provision of 26 services, grouped into five types:
assessment, substance abuse therapy and counseling, testing, transitional,
and other. This short report provides information on the distribution
of these services across substance abuse treatment facilities by such
characteristics as the availability of special treatment programs or groups,
facility size, and ownership.
Distribution of Services
The services most frequently provided
were individual therapy (95 percent), comprehensive substance abuse assessment/diagnosis
(93 percent), group therapy (89 percent), and referral to other transitional
services (84 percent) (Table 1). Substance abuse treatment facilities averaged
14 services per facility.
More than one-third (37 percent) of facilities provided 11 to 15 services,
while more than one-quarter (28 percent) provided 16 to 20 services (Figure
1).
| Figure
1. Percent of Facilities Providing Specified Numbers of Services:
2000 |
|
| Source:
2000 SAMHSA National Survey of Substance Abuse Treatment Services
(N-SSATS). |
| Table
1. Distribution of Services Provided by Substance Abuse Treatment
Facilities: 2000 |
| Type
of Service |
Percent of Facilities Providing a Service |
| Assessment
Services |
|
| Comprehensive
Substance Abuse Assessment/Diagnosis |
93 |
| Comprehensive
Mental Health Assessment/Diagnosis |
44 |
| Substance
Abuse Therapy and Counseling |
|
| Individual
Therapy |
95 |
| Group
Therapy (Not Including Relapse Prevention) |
89 |
| Family
Counseling |
78 |
| Aftercare
Counseling |
77 |
| Relapse
Prevention Groups |
77 |
| Pharmacotherapies/Prescription
Medication |
42 |
| Testing |
|
| Drug/Alcohol
Urine Screening |
79 |
| Blood
Alcohol Testing (Including Breathalyzer) |
45 |
| TB
Screening |
38 |
| HIV
Testing |
33 |
| Hepatitis
Testing |
25 |
| STD
Testing |
25 |
| Transitional
Services |
|
| Referral
to Other Transitional Services |
84 |
| Discharge
Planning |
81 |
| Assistance
with Obtaining Social Services |
51 |
| Employment
Counseling/Training |
35 |
| Housing
Assistance |
31 |
| Other
Services |
|
| Case
Management Services |
66 |
| HIV/AIDS
Education/Counseling/Support |
55 |
| Outcome
Follow-Up (Post-Discharge) |
49 |
| Transportation
Assistance to Treatment |
36 |
| Domestic
Violence–Family/Partner Violence Services |
34 |
| Child
Care |
10 |
| Acupuncture |
5 |
|
| Source:
2000 SAMHSA National Survey of Substance Abuse Treatment Services
(N-SSATS). |
Specially Designed Treatment Programs or Groups
Facilities with a specially designed
treatment program or group for adolescents were more likely than facilities
without such a program to offer family therapy (91 vs. 69 percent).
Facilities with a specially designed treatment program or group for clients
with co-occurring substance abuse and mental health disorders were more
likely than facilities without such a program to offer mental health assessment
(62 vs. 26 percent) and pharmacotherapy (57 vs. 27 percent).
Facilities with a specially designed treatment program or group for persons
with HIV/AIDS were more likely than facilities without such a program to
provide each of the six testing services (Table 2).
Facilities with a specially designed treatment program or group for pregnant
women were more likely than facilities without such a program to provide
social services (68 vs. 47 percent), child care assistance (28 vs. 5 percent),
and domestic violence education (49 vs. 30 percent).
| Table
2. Testing Services, by Presence of HIV/AIDS Treatment Program
or Group: 2000 |
| |
Facilities
w/ HIV/AIDS Treatment Program/Group (n=2,893) |
Facilities
w/out HIV/AIDS Treatment Program/Group (n=10,520) |
| Type
of Test |
Percent
of Facilities |
| Drug/alcohol
urine |
86 |
77 |
| TB |
55 |
33 |
| HIV |
55 |
27 |
| Blood
alcohol |
53 |
43 |
| Hepatitis |
42 |
21 |
| STD |
41 |
20 |
|
| Source: 2000 SAMHSA National Survey
of Substance Abuse Treatment Services (N-SSATS). |
Facility Size
When facilities were divided into
five equal-sized groups by number of clients in treatment on October 1,
2000, the average number of services provided ranged from 12 in the very
small facilities (1 to 12 clients) to 15 in the very large facilities
(105 to 3,000 clients).1
The distribution of services within size groups showed that as facility
size increased, the number of services provided also increased (Table
3). While 5 percent of the very small facilities provided the highest
number of services (21-26), almost 3 times as many (14 percent) of the
very large facilities did.
The services with the largest percentage point difference between very
small and very large facilities were as follows:
• relapse prevention therapy (22 percentage points)
• pharmacotherapy, blood alcohol testing, and HIV education (21 percentage
points)
• drug/alcohol urine screening (19 percentage points)
These were the services with the smallest percentage point difference
between very small and very large facilities:
• outcome follow-up (2 percentage points)
• comprehensive mental health assessment, individual therapy, and family
counseling (5 percentage points)
• domestic violence services (6 percentage points)
| Table
3. Facilities Providing Specified Numbers of Services, by Facility
Size (Average Number of Clients): 2000 |
| |
Size
of Facility and (Average Number of Clients) |
| Number
of Services Provided at a Facility |
Very
Small (7) |
Small
(19) |
Medium
(36) |
Large
(71) |
Very
Large (242) |
|
Percent
of Facilities |
| 1-5
Services |
9 |
5 |
3 |
3 |
2 |
| 6-10
Services |
30 |
23 |
22 |
20 |
15 |
| 11-15
Services |
34 |
38 |
39 |
38 |
36 |
| 16-20
Services |
22 |
26 |
28 |
29 |
33 |
| 21-26
Services |
5 |
8 |
8 |
10 |
14 |
| Total |
100 |
100 |
100 |
100 |
100 |
|
| Source: 2000 SAMHSA
National Survey of Substance Abuse Treatment Services (N-SSATS).
|
Managed Care
Facilities with a managed care contract
provided, on average, a slightly smaller number of services than facilities
without managed care contracts (13 vs. 14). However, facilities with a managed
care contract were more likely than facilities without such a contract to
offer mental health assessment (53 vs. 34 percent), family therapy (86 vs.
68 percent), and pharmacotherapy (50 vs. 32 percent).
Ownership
The average number of services per
facility by type of ownership ranged from 17 services in Federal government
facilities to 12 in private for-profit facilities. Private non-profit facilities
and those owned by tribal governments provided an average of 14 services;
those owned by local governments provided an average of 15 services; and,
those owned by State governments provided an average of 16 services.
Testing services differed more than other types of services by type of facility
ownership. Facilities owned by the Federal government were more likely to
provide each of the six tests, with the exception of drug/alcohol urine
screening, which was more likely to be provided by State government facilities
(Table 4). Drug/alcohol urine screening, provided by 79 percent of all facilities,
was the test most likely to be offered at any facility, regardless of ownership.
Private for-profit facilities were least likely to provide four of the tests
(hepatitis, HIV, STD, and TB). Blood alcohol testing and drug/alcohol urine
screening were least likely to be provided by tribal government facilities.
Table
4. Testing Services, by Type of Facility Ownership: 2000
|
| |
Private
for-profit (n=3,476) |
Private
non-profit (n=7,981) |
State
Gov’t. (n=414) |
Local/County
Gov’t. (n=1,066) |
Tribal
Gov’t. (n=170) |
Federal
Gov’t. (n=310) |
| Type
of Test |
Percent
of Facilities |
| Blood
alcohol |
43 |
44 |
58 |
49 |
28 |
74 |
| Drug/alcohol
urine |
75 |
81 |
88 |
76 |
58 |
85 |
| Hepatitis |
20 |
25 |
45 |
26 |
28 |
70 |
| HIV |
21 |
36 |
49 |
37 |
29 |
74 |
| STD |
19 |
24 |
52 |
25 |
26 |
64 |
| TB |
28 |
38 |
66 |
46 |
36 |
68 |
|
| Source: 2000 SAMHSA National Survey
of Substance Abuse Treatment Services (N-SSATS). |
End Note
1Facilities
were divided into five groups of approximately 2,480 facilities each, based
on number of clients in treatment on October 1, 2000: very small (average
7 clients, range 1 to 12 clients); small (average 19 clients, range 13 to
25 clients); medium (average 36 clients, range 26 to 48 clients); large
(average 71 clients, range 49 to 104 clients); and very large (average 242
clients, range 105 to 3,000 clients). See Substance Abuse and Mental Health
Services Administration (2003, June 6). The DASIS Report. Variations
in Substance Abuse Treatment Facilities by Number of Clients. Rockville,
MD: Author.
|
