Compartmentalization in the Treatment of Patients Diagnosed with Substance Abuse Problems - Research Proposal Example

Mental health versus substance abuse treatment programs for dually diagnosed patients Alternative Research Paper Overview of the Chosen Article There lies a compartmentalization in the treatment of patients diagnosed with substance abuse problems and patients with psychological problems. Medical administration oftentimes disregard that there is a duality and parallelism between substance abuse and psychological findings. “Regier et al. (1990) reported greater than a two-fold increased odds of having a co-occurring alcohol or drug disorder among persons with an existing psychiatric diagnosis relative to those without a diagnosis of a mental condition. Among those with an alcohol disorder, 37% had comorbid mental disorder, while 53% of those with illicit drug diagnoses had another lifetime mental disorder” (as cited in Primm, et al. 2000) establishes the subsistence of concurrence between the two diagnoses among patients. The previous study ascertains that alcohol and drug abuse among psychiatric patients increases the probability for a doubled chance of co-occurrence. The fundamental aim of the study titled Mental Health versus Substance Abuse Treatment Programs for Dually Diagnosed Patients is to determine which program is more appropriate for patients with both conditions. (this is not a quote, this is the title of the paper, You need to add who the quote is from.) Primm et al. (2000) conducted a study with 129 voluntary outpatients with both substance abuse and psychological problems in two separate Johns Hopkins Hospital Community Psychiatry Programs, 65 of which are undergoing treatment for substance abuse disorders at JHH Program for Alcoholism and Other Drug Dependencies while the remaining 64 are under psychiatric medication program at Mental Illness and Substance Abuse (MISA). Other factors pertaining to socio-demographic data were also considered. The researchers noted the differences among the groups such as variation in levels of schizophrenia particularly in the MISA group where such is recorded for study variables’ purposes. The study identified that the patients selected which program they entered into and placed themselves according to the severity of their condition, mental health, and substance abuse. Also, the researchers recorded that drug abuse problems include a majority of respondents already with medical problems which may be reflective of their socio-economic status. The need for clinicians to heighten sensitivity to the needs of individuals diagnosed with both problems is a primary concern raised in this study. The economic restrictions of the patients may prevent them from obtaining proper diagnosis necessary for appropriate treatment whether it be for substance abuse, mental disorder, or most likely both. Primm et al. argues in their findings that “The fact that patients in the substance abuse treatment group sought treatment for their substance use disorder in a substance abuse treatment setting is an indication of the higher rate of psychiatric disorders that are not considered to be severe or persistent mental conditions (such as schizophrenia).” The study provided other factors such as marital status, offspring, race, age, gender, ethnicity and criminal history. There was a similarity in ethnicity as majority is African-Americans with 36 as the mean age for the two groups. The MISA components composed of majority men while substance abuse patients are evenly dispersed among men and women. Other notable findings include that marriage is not particular between groups but substance treatment patients have more experience in marital history. About 75% in the substance group are parents particularly. Disability benefits were almost non-existent in the substance abuse program. “MISA group, however, there was a predominance of patients in the following categories: those who were male, those who had never married, those who carried a diagnosis of schizophrenia and those who had been classified as disabled. In contrast, the majority of patients in the substance abuse group had the following attributes: having children, being diagnosed with a comorbid affective disorder, and having medical problems” (Primm et al., 2000). Incidence of schizophrenia was recorded to be leaning more towards men while affective disorders are more evident among women but this does not translate that this significantly concern the gravity of substance abuse between the two disorders. Though a number of the patients have criminal records, this is attributed to the violence shown by psychiatric and substance abuse patients who often ignore taking their medication. Lima and Pai (as Primm et al. has cited) had found that schizophrenia patients do not extensively report their medical issues unlike neurosis patients even though they are comparatively most likely to have worst medical conditions (2000). Discussion of the Rationale for Choosing a Qualitative Research The researchers regarded that the study is important in intensifying the awareness of medical practitioners in diagnosing patients and providing for them the most appropriate medical treatment for multiple medical issues as overlooking such could complicate complications in both substance abuse and psychiatric issues among misdiagnosed patients. In this sense, a qualitative research is the most appropriate approach in conducting the study in order to explain the phenomenon. They have recognized in the process that the patients have limited economic resources which may be characterized by the geographic location and clientele of the institution, nonetheless, attention to the patients must still be strictly adhered upon (Primm, et al., 2000). Qualitative method of research was used in order to identify the reason behind why the patients choose which program to enroll in. This is the most appropriate as the study is a means to understand the behavior of the respondents. In the course of the research, the two focus groups served as the foundation of the study. Observation was an important function of the researchers as well as the accumulation of data for comparative purposes. Data analysis was presented in table formats. Specifically, two tables were shown where one contains the socio-demographic data including other factors and its frequency distribution while the other places side by side the psychiatric diagnoses including medical history frequency distribution of patients from both focus groups. A qualitative research was employed because the study is geared towards answering the question why. Its primary concern is the development of an elucidation on currently occurring social phenomena. It is thus a more social approach to research and the world in a wider perspective (Hancock, 2002). Setting parameters is an important aspect of qualitative research. The set parameters will indicate the limitations and delimitations of the study to ensure that it is within the bounds of the production of a good research. This type of study constitutes an open nature whereas it is not uncommon for the researchers to suddenly find something peculiar in the course of the production of the paper (Sandelowski & Barroso, 2007). Appropriateness of the chosen strategy The appropriateness of a chosen method in every research is that it “enables the readers to clearly understand how researchers went about the work of investigating the issue, including who was involved, what information was collected, and how the information was analyzed” (Stringer, 2007). It is also important that those who are reading the research paper understand how the relationship between the research facilitator and other participants helped to shape the processes and outcomes of the investigation. With regard to this case study, the MISA sample included 64 patients and the substance abuse treatment group included 65 patients, who were admitted to these programs and met criteria for having dual diagnoses. The MISA sample was a complete sample of the records of patients enrolled in the MISA program from 1996-1997. The substance abuse treatment patients included all who received a diagnosis based on the ‘Diagnostic and Statistical Manual of Mental Disorders’ (American Psychiatric Association, 1994). There are times when researchers would discover something that they have not anticipated. Therefore, it is vital that they decide on the previous sets of research that they would include. This decision often depends on whether they should include research that has a general appeal to their subject or should they stick to specific research with regard to the topic (Sandelowski & Barroso, 2007). In the case of the research, it has ultimately included other studies which has varied range that aim to answer specific parts of the conducted study. This is to show a comparative appraisal of the topic. The content and statistical findings were summarized and presented next to other studies of the same nature to show its relevance and difference in findings. This provides material to remarkably estimate the significance of the study conducted. The study contained the necessary aspects of a qualitative study as indicated by Sandelowski and Barroso (2007) which are initial topic, population, temporal and methodological, all of which answer the questions what, who, when and how respectively. The previous research to be compared and contrasted is the focus of topic. Defending the parameters of the population is then discussed. Here is the comaparative analysis between the two focus groups. The temporal part of the research is the timeframe of the study. In here, the concern was mainly on the convenience of the researchers. The method is among the most central facet as it compels the study to have individual (intra-report) and comparative (inter-report) analysis. Both of these were processed in the study of dually diagnosed patients as indicated. Treatment in the MISA program consists of a 5-day a week compulsory program in which patients attend a series of group interactions, including 12-step program adapted for patients with severe and persistent mental illness. The substance abuse program is a 7-day per week format in which groups, individual counseling, and methadone maintenance (for patients with opiate dependence) is included. “To better understand the research, the readers should be informed of the number and type of people who participate in the investigation (called “the sample” in quantitative studies) and the way the participants were chosen (sampling procedures) so they will clearly understand the sources of information” (Stringer, 2007). This type of information was clearly established in this research project. The researchers used as they have explained exploratory statistics which shows the differences of particular characteristics among the population groups among patients. Chi-square test to be able to evaluate proportions appropriately was utilized “expect where expected cell counts were less than five, in which case Fisher’s exact test was employed. To compare mean age, the two sample t-test for equality of means was used” (Primm, et al., 2000). All of the above mentioned methods were suitable for this type of research. In order to calculate the information precisely it was imperative to use this type of statistical data collection to obtain the most accurate results. Conclusion: The research appropriately articulated the findings which aimed to identify the reasons behind the issue that come with it. This is what a qualitative research is supposed to do. A study should be compared and contrasted with already existing published research and literature including other documentations regarding the topic. This presents what had been discovered and explored through the understanding of the findings. The conclusion voices the concerns of the participants and their needs. Through such studies the researchers draw on and develop literary devices that are able to reflect the deeply felt realities of people’s day-to-day lives. In this case study it argues that what the researchers discovered was clearly explained and easy to understand. The results of the research indicate that there were similarities in the MISA group and the substance abuse treatment group with regards to age, ethnicity, and self-reported criminal history. However in the MISA group there were a large number of patients who were male, those who had never married, those who carried a diagnosis of schizophrenia and those who had been classified as disabled. In contrast, the majority of patients in the substance abuse group were women who carried the attributes such as, having children, being diagnosed with co-morbid affective disorder, and having medical problems. In regards to ethnicity between the two groups, was a reflection of the majority of residents of the geographical area where the two programs were located, the urban setting of East Baltimore. These were further explained by the researchers in terms of its logical explanation and weight to the course of the study conducted. A need for better comprehension of identifying psychological symptoms for proper management of co-morbid cases is what the study proposes. A person who is diagnosed with a psychiatric disorder while having treatment for substance abuse must then be eligible to get disability benefits which are not regularly accessible to solely substance abuse patients. A Qualitative type of research was the best means to conduct this study. It provided Primm et al. with ease in the collection of data that led to their conclusion because there was a set population for their data collection. It was the most time efficient means for them to develop their hypothesis as it was a matter of inductive reasoning particular of a qualitative research in the field of medicine. “The public health importance of this study focuses on being able to identify and increase the sensitivity of professionals to the special needs of patients with dual diagnoses and to improve services to patients with these disorders. This is particularly important for populations at higher risk for medical and psychiatric complications, and those with fewer health-care resources because of socioeconomic limitations, lower educational attainment, and minimal available social supports” (Primm, et al., 20000). As researches, the end goal is to bring about awareness to a problem or social change that is necessary for people to improve and for the society to progress. This research was important for a deeper understanding of the circumstances of these people and for their problems to be recognized and acknowledged. Bibliography Hancock, B. (2002). Trent focus for research and development in primary health care: an introduction to qualitative research. Nottinghan: Trent Focus Group. Primm, A. B., Gomez, M. B., Tzolova-Iontchev, I., Perry, W., Hong, T. V., & Crum, R. M. (1999). Mental health versus substance abuse treatment programs for dually diagnosed patients. Journal of Sunstance Abuse Treatment , 287-290. Sandelowski, M., & Barroso, J. (2007). Handbook for synthesizing qualitative research. New York: Springer Publishing Company. Stringer, E. (2007). Action research. Sage Publications, Inc. Read More