oviders, which was compared to 76% for adults and 51% for the elderly (Harwood, et al., 2003).
Timko, Lesar, Calvi, and Moos (2003) examined trends in acute mental health care to include psychiatric and substance abuse treatment programs. In the past there was a distinct difference between substance abuse treatment programs and psychiatric treatment programs; each was licensed and monitored under different authorities and each provided different services based on different philosophies and procedures. These two systems have separate financing and compete for public health funds. More recently these two systems have changed with a shift from inpatient to residential care. The community residential treatment center assumes a larger role of care and involves new management practices for both systems. Along with these changes both systems now have a large prevalence of dual diagnosis patients. Despite differences in treatments there is a common ground for treating substance use disorders and psychiatric disorders. The Veterans Affairs' (VA) psychiatric and substance abuse programs are found nationwide and are publicly funded by the federal government; the VA provides the largest of these systems in the United States.
Timko, et al., (2003) compared different programs with inpatient and residential options of care to determine the organization, staffing, management practices and policies, services, and activities in psychiatric and substance abuse treatment programs. Surveys were distributed to 412 Department of Veterans Affairs programs nationwide. Findings showed that 50% of patients in substance abuse or psychiatric programs had dual diagnoses in both inpatient and residential programs. The psychiatric programs provided fewer services than substance abuser programs, however mental health programs had a strong emphasis on using clinical practice guidelines, monitoring performance, and assessing client satisfaction and outc...