Substance abuse treatment client experience in an employed population: results of a client survey

Employees covered by a large MBHO who had received substance abuse services in the past year were surveyed (146 respondents completed the telephone survey and self-reported service use).The most common reasons for entering treatment were problems with health; home, family or friends; or work. Prior treatment users reported more reasons for entering treatment and more substance use-related work impairment. The majority of all respondents felt treatment helped a lot or some. One quarter reported getting less treatment than they felt they needed.Study findings point to the need to tailor treatment for prior service users and to recognize the role of work in treatment entry and outcomes. Perceived access issues may be present even among insured clients already in treatment.Improving care for substance use conditions includes making health care more patient-centered and accessible, according to the Institute of Medicine [1]. Understanding client perspectives on treatment and its results is increasingly recognized as key to improving care.Most private health plans in the United States contract with managed behavioral health care organizations (MBHOs) for specialty behavioral healthcare,[2] as do many employers. MBHOs are specialized vendors that typically offer provider networks and utilization management specifically for behavioral health. Yet, there is little information available on the perceptions and experience of employees with employer-sponsored health coverage who receive help for substance use conditions, particularly when covered by MBHOs. These may be quite different from a public-sector treatment population or mixed populations of working and non-working individuals. Furthermore, the role of prior service use and certain sociodemographic characteristics has not been fully explored in this group.Numerous studies have examined specific aspects of the treatment experience, from reasons for entering care to outcomes. A substantial body of literature on help-seekin