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Special Report
Preventive Interventions
Under Managed Care: Mental Health
and Substance Abuse Services
Findings
Of the 54 studies that met the criteria for inclusion in this
review, 27 (50%) addressed mental health; 17 (31%)
addressed substance use/abuse (drug use, 4; alcohol abuse,
5; tobacco use, 8). The other 10 (19%) addressed the effects of self-care,
education, and clinical preventive services on overall well-being and
associated medical care utilization. In terms of developmental categories,
the majority of studies utilized adult subjects between the ages of 18 and
64 (29 or 54%). Fourteen studies included adolescents between the ages
of 13 and 17 (26%); 10 focused on families, 10 had a population
encompassing adults age 65 and older, and 10 had children to age 12 as
subjects (19%). There were six studies on infants (11%) and five pre-natal
or pregnancy studies (9% each).
All articles included in this review document
positive outcomes of preventive interventions
in relation to mental health or
substance abuse. Thirteen of the 54 articles
(22%) address the cost of the intervention.
Table 1 summarizes the studies included
in this review by the developmental stage
of research subjects, first author, year of
publication, and whether or not the article
provides information about the cost impact
of the evaluated intervention. The parenthetical
number after year of publication
corresponds to the numbered summaries in
Appendix C. Studies with subjects from
more than one developmental stage are
included in each relevant category, and
thus may be listed more than once.
Overall, these studies represent the body
of science-based evidence that interventions
designed to prevent substance abuse and
mental health problems have been proven
effective and, in some cases, have produced
net cost savings or have offset costs that
would have been incurred absent the preventive
intervention. The 54 literature summaries
in Appendix C describe the research subjects,
interventions, and evaluation designs, and
report the study outcomes. The six interventions
with the strongest supportive evidence
are listed and described in Chapter 7.
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