Chapter 5
Client Characteristics

Facility Operation and Primary Focus Type of Care Substance Abuse Problem and Co-occurring Mental Health Disorders
Type of Counseling Clients Under Age 18  

This chapter describes key characteristics of the 1,135,425 clients in substance abuse treatment on March 30, 2007. Clients in treatment were defined as: 1) hospital inpatient and residential (non-hospital) clients receiving substance abuse treatment services on March 30, 2007, and 2) outpatient clients who were seen at the facility for a substance abuse treatment or detoxification service at least once during the month of March 2007, and who were still enrolled in treatment on March 30, 2007. The majority of tables in the report are organized according to facility operation and the primary focus of the facility. Facility operation indicates the type of entity responsible for the operation of the facility: private for-profit; private non-profit; or government—local, county, or community; State; Federal; or tribal. Primary focus indicates the services the facility primarily provides: substance abuse treatment services, mental health services, a mix of mental health and substance abuse treatment services, general health care, or other.

Facility Operation and Primary Focus

Table 5.1. Fifty-five percent of the 1,135,425 clients in treatment on March 30, 2007, were in facilities operated by private non-profit organizations, and 30 percent were in facilities operated by private for-profit organizations. Eight percent of clients were in local government-operated facilities, 4 percent were in State government-operated facilities, 3 percent were in Federal government-operated facilities, and 1 percent were in facilities operated by tribal governments.

Two-thirds (68 percent) of all clients in treatment on March 30, 2007, were in facilities whose primary focus of activity was the provision of substance abuse treatment services. About one quarter (26 percent) of clients were in facilities whose primary focus of activity was a mix of both mental health and substance abuse treatment services. Four percent of clients were in facilities primarily providing mental health services, and 1 percent were in facilities with a general health care focus.

Type of Care

Tables 5.2a, 5.2b, and 5.2c. The 2007 N-SSATS requested data on clients in treatment on March 30, 2007, who received:

Table 5.2b. The majority (90 percent) of the 1,135,425 clients in treatment on March 30, 2007, were enrolled in outpatient treatment. Nine percent were in residential (non-hospital) treatment, and 1 percent were in hospital inpatient treatment.

Just over half (52 percent) of the clients in treatment on March 30, 2007, were in regular outpatient treatment, 22 percent were in outpatient methadone/buprenorphine maintenance, 12 percent were in intensive outpatient treatment, 2 percent were in outpatient day treatment or partial hospitaliza­tion, and 1 percent were in outpatient detoxification. In addition, 6 percent of all clients were in long-term residential treatment, 2 percent were in short-term residential treatment, and 1 percent were in residential detoxification.

In each of the operational categories and for each facility focus of activity, clients most frequently received regular outpatient services. However, there was variation for the other types of care delivered. Private non-profit facilities had a more balanced range of types of care (55 percent of clients were in regular outpatient treatment, 16 percent in outpatient methadone/buprenorphine maintenance, and 13 percent each in intensive outpatient and residential treatment). In private for-profit facilities, 43 percent of clients were in regular outpatient treatment, while 38 percent were in outpatient methadone/buprenorphine maintenance. In facilities operated by State governments, 47 percent of clients were in regular outpatient treatment, 25 percent were in outpatient methadone/buprenorphine maintenance, and 11 percent in residential treatment. In facilities whose focus was substance abuse treatment, 44 percent were in regular outpatient treatment, 30 percent were in outpatient methadone/buprenorphine maintenance, and 11 percent were in residential treatment. In facilities focused on providing mental health services, the range of types of care was limited, with 79 percent of clients receiving regular outpatient treatment.

Table 5.2c. The majority of clients (55 percent) were in private non-profit facilities. This was true for most of the individual types of care. However, the majority of clients in outpatient detoxification (59 percent) were in private for-profit facilities, as were the majority of clients in outpatient methadone/buprenorphine maintenance (51 percent). More than three-quarters (76 percent) of clients in residential treatment (and 80 percent of clients in long-term residential treatment) were in facilities operated by private non-profit organizations.

Substance Abuse Problem and Co-occurring Mental Health Disorders

Table 5.3. On March 30, 2007, 45 percent of all clients were in treatment for both alcohol and drug abuse. Thirty-six percent were in treatment for drug abuse only, and 19 percent were in treatment for alcohol abuse only. Thirty-seven percent of clients were in treatment for co-occurring substance abuse and mental health disorders.

Private for-profit facilities had the smallest proportion of clients in treatment for both alcohol and drug abuse (33 percent), and the highest proportion in treatment for drug abuse alone (49 percent). Clients in treatment for abuse of alcohol alone were found in the highest proportions in Federal government-operated facilities (34 percent). Co-occurring substance abuse and mental health disorders were also found in the highest proportions in Federal government-operated facilities (53 percent).

Facilities providing mental health services had the highest proportion of clients in treatment for co-occurring substance abuse and mental health disorders (64 percent), followed by facilities providing general health care (54 percent), and facilities focused on a mix of mental health and substance abuse treatment services (49 percent). Substance abuse treatment services had the highest proportion of clients in treatment for abuse of drugs alone (42 percent), compared with a range of 22 percent to 25 percent in facilities focused on provision of other services. In turn, facilities providing substance abuse treatment services had the smallest proportion of clients in treatment for abuse of alcohol alone (16 percent), compared with a range of 23 percent to 34 percent in facilities providing other services.

Type of Counseling

Table 5.4. Virtually all (99 percent) of facilities included counseling as part of their substance abuse treatment programs [Table 4.8]. However, the proportion of clients in any given type of counseling on March 30, 2007, was considerably lower. Most clients (79 percent) were in individual counseling, 71 percent were in group counseling, 22 percent were in family counseling, and 8 percent were in marital/couples counseling.

There was little variation in the proportions of clients by facility operation. Private non-profit facilities had slightly higher proportions of clients in individual, group, and family counseling than did private for-profit facilities, which in turn had a higher proportion in marital/couples counseling. Government-operated facilities had slightly higher proportions of clients in group counseling than in individual counseling.

There were greater differences in the proportions of clients in counseling by facility focus. Facilities whose primary focus was the provision of substance abuse treatment had the highest proportions of clients in individual and group counseling (84 percent and 73 percent, respectively), while the lowest proportions were in facilities focused on providing mental health services (62 percent and 45 percent, respectively). Facilities providing a mix of mental health and substance abuse treatment services had the highest proportions of clients in family and marital/couples counseling (24 percent and 12 percent, respectively).

Clients Under Age 18

There were 85,518 clients under age 18 in substance abuse treatment on March 30, 2007, some 8 percent of the total 1,135,425 clients in treatment on that date.

Table 5.5. Clients under age 18 in substance abuse treatment on March 30, 2007, were more likely to be in private non-profit facilities than the general client population (64 percent and 55 percent, respectively) [Table 5.1]. Private for-profit facilities accounted for 30 percent of all clients in treatment, but only 20 percent of clients under age 18.

Fifty-five percent of clients under age 18 were in facilities with a primary focus of substance abuse treatment, compared to 68 percent of all clients. A little more than one third (37 percent) of clients under age 18 were in facilities whose focus was provision of a mix of mental health and substance abuse services, compared to 26 percent of the total client population.

Table 5.6. The proportion of adolescents receiving each type of care was similar to the total treatment population [Table 5.2b]. Most (87 percent) were in outpatient treatment, 12 percent were in residential (non-hospital) treatment, and 1 percent were in hospital inpatient treatment.

To Tables

To table of contents
To Table of Contents