Providers' Institutional Settings, 1980-1992

Specialty substance abuse treatment services, like other forms of health care, are delivered in different locations, settings, or institutions. NDATUS classifies providers loosely in terms of their institutional setting. Note that "free-standing" means that the provider delivers only substance abuse treatment. All other institutions deliver substance abuse as a specialized unit within a larger health care or correctional institution.

Over half (54%) of the estimated daily clients in 1992 received treatment in free-standing outpatient facilities. Specialized programs in community mental health centers treated 16%, followed by general hospitals (10%).

• All settings reported at least some outpatient clients. Many clients reported as in 24-hour care in halfway houses are outpatient in the sense that they work and do other activities off site during the day but reside in the facility at night.

• Between 1980 and 1992, specialized outpatient facilities gained substantially in their proportion of total reported clients, going from 40% to 54%. The proportion of clients reported by criminal justice providers also increased slightly, but the proportion of clients declined for every other setting during this 12 year period. However, hospitals appeared to gain share between 1991 and 1992.

Clients in Specialty Substance Abuse Treatment by Institutional Setting

                                   Percent
                1980   1982   1984   1987   1989   1990   1991   1992

Free-standing
  outpatient    40.4   37.2   43.5   49.9   51.2   49.9   52.5   53.6
Community mental
  health center 19.5   21.0   20.8   14.5   15.0   17.0   16.5   15.6
General hospital
  (incl VA)     10.1   11.5   12.5   10.3    8.9    8.1    7.7    9.7
Residential
  facilities     6.4    5.6    4.2    7.4    7.0    6.3    6.4    6.8
Specialized
  hospitals      3.9    3.7    3.5    4.4    3.4    2.4    2.0    2.8
Halfway house/
  Recovery home  3.7    3.1    4.0    2.8    2.5    2.3    1.9    2.4
Correctional
  facilities     2.5    2.2    2.0    1.5    1.9    3.4    4.8    3.2
Other types     13.7   15.6    9.5    9.3   10.0   10.6    8.2    5.8

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