Models of standard and intensive outpatient care in substance abuse and psychiatric treatment

Adm Policy Ment Health. 2003 May;30(5):417-36. doi: 10.1023/a:1024693614501.


Intensive outpatient mental health programs are proliferating rapidly. However, findings suggest that intensive treatment may be no more effective than standard treatment. This study compared standard to intensive outpatient programs, within both the psychiatric and substance abuse systems of care, on organization, staffing, and treatment orientation; clinical management practices; and services. A total of 723 (95% of those eligible) Department of Veterans Affairs programs were surveyed nationwide. Psychiatric intensive programs have responded appropriately to their more severely ill patients in terms of the amount and orientation of care, and having a rehabilitation focus. However, the relative lack of basic psychiatric services in psychiatric intensive programs, and the overall similarity of substance abuse standard and intensive programs, may explain why intensive programs have not yielded patient outcomes that are superior to those of standard programs. Mental health system planners should consider differentiating intensive programs using broader criteria and methods.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Ambulatory Care / classification
  • Ambulatory Care / organization & administration*
  • Ambulatory Care / standards
  • Critical Care
  • Diagnosis, Dual (Psychiatry)
  • Health Care Surveys
  • Humans
  • Mental Disorders / rehabilitation
  • Mental Disorders / therapy*
  • Mental Health Services / classification
  • Mental Health Services / organization & administration*
  • Mental Health Services / standards
  • Models, Organizational*
  • Personnel Staffing and Scheduling
  • Substance-Related Disorders / rehabilitation
  • Substance-Related Disorders / therapy*
  • United States
  • United States Department of Veterans Affairs*