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NOMs 101: National Outcome Measures

The Substance Abuse and Mental Health Services Administration's (SAMHSA) National Outcome Measures (NOMS) are an effort to develop a reporting system that will create an accurate and current national picture of substance abuse and mental health services. The NOMS serve as performance targets for state- and Federally-funded programs for substance abuse prevention and mental health promotion, early intervention, and treatment services.

The NOMs embody meaningful, real life outcomes for people who are striving to attain and sustain recovery; build resilience; and work, learn, live, and participate fully in their communities. Within NOMS there are 11 priority areas, one of which addresses co-occurring disorders (COD). Each area is subdivided into three areas:

  • Mental health services
  • Substance abuse treatment
  • Substance abuse prevention

Each area is further subdivided into ten domains:

  • Reduced Morbidity
  • Employment/Education
  • Crime and Criminal Justice
  • Stability in Housing
  • Social Connectedness
  • Access/Capacity
  • Retention
  • Perception of Care (or services)
  • Cost Effectiveness
  • Use of Evidence-Based Practices

Because of challenges to isolate COD data and examine it independently, data for this priority area is monitored under two domains: 1) Reduced morbidity; and 2) Social connectedness. Outcome measures are developed under each domain.

Outcomes are populated with three national-level SAMHSA data sets:

  • National Survey on Drug Use and Health (NSDUH) and National Survey of Substance Abuse Treatment Services (N-SSATS). This data is defined by the Treatment Episode Data Set (TEDS). TEDS is not required reporting in all States/jurisdictions and comes primarily from public substance abuse treatment facilities. Data is collected from the approximately 1.8 million annual admissions.
  • Center for Mental Health Services (CMHS) Uniform Reporting System (URS). This data is collected voluntarily by states with most data derived from public mental health systems. Large variation ranges exist in this data due to systems, capacity, collection methods, and variable definitions.
  • Drug Abuse Warning Network (DAWN). This data is collected from emergency room visits and medical examiner reports

The major challenge to examining NOMs among individuals with co-occurring disorders is limited data. These three data sets may provide possible baseline determinations. Presently, co-occurring disorder data is monitored by the following:

  • Substance abuse prevention. Data cannot be isolated, but is monitored under two domains: 1) Reduced morbidity (abstinence); and 2) Social connectedness
  • Substance abuse treatment/mental health services. Data is available and monitored under Access/Capacity via URS and the NSDUH. Retention data is provided via TEDS.

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