Utilizing Peer Mentorship to Engage High Recidivism Substance-Abusing Patients in Treatment

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Abstract
Background: Often high recidivism substance-using patients have difficulty connecting to outpatient treatment contributing to greater functioning disturbances. Approaches to address this problem frequently are staff extensive. Objective: This study evaluates the impact of peer mentorship and/or enhanced dual recovery treatment (DRT) on individuals who are inpatients, substance abusing, and have a history of high recidivism. The primary outcome is post-discharge treatment attendance. Methods: In an inpatient Veterans Administration hospital setting, 96 patients with a history of high recidivism and current and/or past diagnosis of substance use disorders were randomized to either (i) Treatment As Usual (TAU), (ii) TAU + DRT + Mentorship for Addictions Problems to Enhance Engagement to Treatment (MAP-Engage), or (iii) TAU + MAP-Engage. Results: Overall MAP-Engage was found to be comparable to the DRT + MAP-Engage and both of these conditions were significantly better than TAU alone at increasing adherence to post-discharge substance abuse, medical, and mental health outpatient appointments. Conclusion/Scientific Significance: MAP-Engage offers an alternative approach to address lack of attendance to outpatient treatment appointments post discharge that is relatively low in staff reliance.

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