M. Audrey Burnam

Adjunct Principal Researcher

Santa Monica Office

Education

Ph.D. in social psychology, University of Texas at Austin; B.A. in psychology, University of Arizona

One Page Bio

Media Resources

This researcher is available for interviews.

To arrange an interview, contact the RAND Office of Media Relations at (310) 451-6913, or email media@rand.org.

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Overview

Audrey Burnam is an adjunct principal researcher at the RAND Corporation. She has been conducting mental health and substance abuse research for more than 30 years and has directed studies to understand the epidemiology of mental health and substance abuse problems and to evaluate delivery of services for persons with these problems. Relevant research includes an experimental evaluation of integrated mental health and substance abuse services for homeless persons with serious mental illness; an evaluation of benefit parity for mental health and substance abuse benefits as part of the Federal Employees Health Benefits Program; an evaluation of community mental health organizations that integrated primary care and mental health care for adults with severe mental illness under a federal grant program; and an evaluation of California's statewide mental health programs for prevention and early intervention. Burnam received her Ph.D. in social psychology from the University of Texas at Austin.

Research Focus

Previous Positions

Manager, Behavioral and Social Sciences Group; Director, Center for Research in Alcohol, Drug Abuse, and Mental Health, RAND Health; Codirector, RAND Drug Policy Research Center

Recent Projects

Integrated primary and behavioral health care
Behavioral health benefit parity
Mental health care for military servicemembers and veterans
Treatment of teen depression in primary care settings
California mental health prevention and early intervention

Selected Publications

Eberhart, N.K., Burnam, M.A., Seelam, R., Bogdon, E., & Breslau, J, Monitoring Californians' Mental Health: Population Surveillance Reveals Gender, Racial/Ethnic, Age, and Regional Disparities, RAND (RR-2060), 2018

McBain, Ryan K., Nicole K. Eberhart, Joshua Breslau, Lori Frank, M. Audrey Burnam, Vishnupriya Kareddy, and Molly M. Simmons, How to Transform the U.S. Mental Health System: Evidence-Based Recommendations, RAND Corporation (RR-A889-1), 2021

Burnam, M.A., Meredith, L.M., Tanielian, T., & Jaycox, L.H., "Mental health care for Iraq and Afghanistan war veterans," Health Affairs, 28(3), 2009

Watkins, K.E., Burnam, M.A., Orlando, M. Escarce, J.J., Huskamp, H.A., & Goldman, H.H., "The health value and cost of care for major depression," Value in Health, 12, 2009

Edelen, M.O., Burnam, M.A., Watkins, K.E., Escarce, J.J., Huscamp, H., Goldman, H.H., & Rachelefsky, G.G., "Obtaining utility estimates of the health value of commonly prescribed treatments for asthma and depression," Medical Decision Making, 28, 2008

Isett, K.R., Burnam, M.A., Coleman-Beattie B., Hyde P.S., Morrissey J.P., Magnabosco J.L., et al., "The role of state mental health authorities in managing change for the implementation of evidence-based practices," Community Mental Health Journal, 44(3), 2008

Burnam, M.A., & Watkins, K.E., "Substance abuse with mental disorders: Specialized public systems and integrated care," Health Affairs, 25(3), 2006

Joyce, G.F., Chan, K.S., Orlando M., & Burnam, M.A., "Mental health status and use of general medical services for persons with Human Immunodeficiency Virus," Medical Care, 43(8), 2005

Publications

Report
How to Transform the U.S. Mental Health System: Evidence-Based Recommendations
The United States is at a time of promise for historic transformation in mental health care. This report provides recommendations for mental health system change to improve the lives of the millions of Americans in need of care.
Jan 11, 2021
Tool
Mental Health Systems Solutions Explorer
This tool is designed by RAND researchers to help connect mental health systems, policy leaders, and decisionmakers with resources and evidence-based solutions that could help transform the complex mental health landscape in the United States.
Jan 11, 2021
Research Brief
Transforming Mental Health Care in the United States
A RAND team identified three goals for transforming the U.S. mental health care system and pinpointed 15 opportunities to drive systemic improvements in access, use, and quality that would help tens of millions of Americans.
Jan 11, 2021
Journal Article
Distress, Impairment, and Racial/Ethnic Differences in Perceived Need for Mental Health Treatment in a Nationally Representative Sample
Differences in perceived need across racial/ethnic groups are not attributable to differences in psychological distress and impairment.
Dec 16, 2020
Journal Article
Mental Health Services and Personal Recovery in California: A Population-Based Analysis
This observational study examined personal recovery in a representative sample of adults in California with elevated psychological distress.
May 12, 2020
Journal Article
Social Marketing of Mental Health Treatment: California's Mental Illness Stigma Reduction Campaign
The California campaign increased service use by leading more individuals to interpret symptoms of distress as indicating a need for treatment.
Oct 10, 2019
Research Brief
Federal Block Grants to States for Mental Health, Substance Abuse, and Homelessness: Potential Improvements to Funding Formulas
RAND researchers analyzed the formulas for distributing funds to states under three block grants for services related to mental health, substance abuse, and homelessness (unchanged since 1992) to determine whether they should be modified.
Jun 19, 2019
Report
Review and Evaluation of the Substance Abuse, Mental Health, and Homelessness Grant Formulas
RAND researchers analyzed the formulas for distributing funds to states under three block grants for services related to mental health, substance abuse, and homelessness (unchanged since 1992) to determine whether they should be modified.
Jun 19, 2019
Report
Evaluation of the Homeless Multidisciplinary Street Team for the City of Santa Monica
The City of Santa Monica, California, implemented the Homeless Multidisciplinary Street Team to address the chronic and persistent problem of homelessness, which burdens public service providers and imposes substantial public costs on the city.
Jun 5, 2019
Tool
Monitoring Prevention Mental Health Programs: Supporting California Counties to Meet Statewide Reporting Requirements
In this document, RAND researchers describe how they developed a tool to help the Los Angeles County Department of Mental Health comply with regulations to report on outcomes for prevention mental health programs.
Sep 28, 2018
Journal Article
Differential Association of Stigma with Perceived Need and Mental Health Service Use
Two stages of the help-seeking process - perceiving a need for mental health treatment and treatment use - are related to different facets of stigma.
Jun 13, 2018
Report
Monitoring Californians' Mental Health: Population Surveillance Reveals Gender, Racial/Ethnic, Age, and Regional Disparities
Data from the California Health Interview Survey can facilitate the state, regional, and county tracking of key mental health indicators, including mental health services, service use, unmet need for services, and mental health-related functioning.
May 1, 2018
Report
Evaluation of the Mental Health Services Act in Los Angeles County: Implementation and Outcomes for Key Programs
This report examines the reach of mental health programs in Los Angeles County and what the impact of those programs has been.
Mar 13, 2018
Research Brief
The Mental Health Services Act in Los Angeles County: Evaluating Program Reach and Outcomes
RAND researchers examined the geographic and demographic reach of Mental Health Services Act-funded activities in Los Angeles County and assessed their impact on clients.
Mar 13, 2018
Report
Evaluation Approaches for Mental Health Prevention and Early Intervention Programs
This handbook provides guidance to practitioners and organizations interested in evaluating mental health prevention and early intervention programs.
Jun 13, 2017
Journal Article
Racial/Ethnic Differences in Perception of Need for Mental Health Treatment in a US National Sample
There racial/ethnic differences in perception of need for mental health treatment; differences exist across the range of severity of mental illness and among those with no mental illness.
May 31, 2017
Journal Article
General Medical Outcomes from the Primary and Behavioral Health Care Integration Grant Program
Rigorous integration of primary and preventive medical services into behavioral health settings may help improve medical outcomes for people with serious mental illness.
Aug 29, 2016
Journal Article
Factors Affecting Mental Health Service Utilization Among California Public College and University Students
Significant need for mental health services exists among college students in California, especially where services are not offered on campus.
Apr 21, 2016
Report
Investment in Social Marketing Campaign to Reduce Stigma and Discrimination Associated with Mental Illness Yields Positive Economic Benefits to California
This report examines the potential impact of the California Mental Health Services Authority's stigma and discrimination reduction social marketing campaign on the use of adult behavioral health services, and it estimates the benefit-cost ratios.
Apr 14, 2016
Research Brief
Campus Climate Matters: Changing the Mental Health Climate on College Campuses Improves Student Outcomes and Benefits Society
Reports results of a survey to assess the impact of state investments in mental health programs at California public colleges and the return on investment in terms of student use of treatment, graduation rates, and lifetime earnings.
Apr 1, 2016
Report
Payoffs for California College Students and Taxpayers from Investing in Student Mental Health
Reports results of a survey to assess the impact of CalMHSA's investments in mental health programs at California public colleges and estimates the return on investment in terms of student use of treatment, graduation rates, and lifetime earnings.
Dec 10, 2015
Research Brief
California's Statewide Mental Health Prevention and Early Intervention Initiatives Show Promising Early Results, But Sustained Investment Is Needed
Summarizes findings from an evaluation of a set of California initiatives to help reduce mental health stigma and discrimination, prevent suicide, and improve student mental health.
Sep 16, 2015
Report
Analysis of the Benefits and Costs of CalMHSA's Investment in Applied Suicide Intervention Skills Training (ASIST)
Estimates the possible reductions in suicide attempts resulting from investment in ASIST and estimates the financial return to Californians from reduced medical costs associated with suicide attempts and increased earnings from each life saved.
May 18, 2015
Research Brief
Should California Continue to Invest in Applied Suicide Intervention Skills Training (ASIST)? ASIST Could Save Lives and Wages and Reduce Medical Costs
Estimates the possible reductions in suicide attempts and deaths resulting from investment in ASIST and the financial return to Californians from reduced medical costs and increased earnings that would result from averted suicide attempts and deaths.
May 18, 2015
Report
Evaluation of California's Statewide Mental Health Prevention and Early Intervention Programs: Summary of Key Year 2 Findings
This report summarizes key findings from the second year of an evaluation of the California Mental Health Services Authority's statewide prevention and early intervention programs.
Feb 3, 2015
Report
Recommendations for Sustaining California's Statewide Mental Health Prevention and Early Intervention Programs
Provides preliminary advice about which of the California Mental Health Services Authority's Prevention and Early Intervention activities seem most valuable to sustain or, in some cases, enhance.
Aug 5, 2014
Research Brief
What Has the CalMHSA Statewide Mental Health Prevention and Early Intervention Implementation Program Done So Far? Key Results from the Baseline RAND General Population Survey
This fact sheet summarizes findings from a baseline statewide survey of Californians regarding their knowledge, beliefs, and attitudes regarding the mental health issues that are the focus of the state' prevention and early intervention program.
Jul 11, 2014
Report
Evaluation of the California Mental Health Services Authority's Prevention and Early Intervention Initiatives: Progress and Preliminary Findings
Evaluates the progress of the California Mental Health Services Authority's statewide Prevention and Early Intervention initiatives.
Jul 3, 2014
Research Brief
Improving the Physical Health of Adults with Serious Mental Illness
RAND's evaluation of the Primary and Behavioral Health Care Integration grants program found that programs improved access to integrated primary and behavioral health care for people with serious mental illness but had mixed success improving health.
May 28, 2014
Report
Evaluation of the SAMHSA Primary and Behavioral Health Care Integration (PBHCI) Grant Program: Final Report (Task 13)
Describes the results of RAND's evaluation of Primary and Behavioral Health Care Integration (PBHCI), one of the Substance Abuse and Mental Health Services Administration's service grant programs.
Apr 21, 2014
Research Brief
What Has the CalMHSA Statewide Mental Health Prevention and Early Intervention Implementation Program Done So Far? Summary and Commentary for Year 1 Evaluation
This fact sheet assesses the progress that partners in California's Prevention and Early Intervention (PEI) Program have made so far in developing capacities and reaching Californians in accordance with the statewide strategic PEI plan.
Mar 4, 2014
Report
Evaluation of the California Mental Health Services Authority's Prevention and Early Intervention Initiatives: Executive Summary and Commentary
Provides a summary and commentary on a RAND interim evaluation of the California Mental Health Services Authority statewide prevention and early intervention program.
Feb 11, 2014
Journal Article
Integrating Primary Care Into Community Behavioral Health Settings: Programs and Early Implementation Experiences
Describes the experiences of community behavioral health agencies that received PBHCI grants from the Substance Abuse and Mental Health Services Administration to integrate primary care into programs for adults with serious mental illness.
2013
Report
Evaluating the Impact of Prevention and Early Intervention Activities on the Mental Health of California’s Population
This report describes a collection of frameworks for evaluating prevention and early intervention funding for mental health services for the California population.
Oct 9, 2012
Journal Article
Development of a Patient-Report Measure of Psychotherapy for Depression
A patient questionnaire is a promising approach for assessing psychotherapy in quality improvement interventions.
May 1, 2010
Research Brief
The Teen Depression Awareness Project: Building an Evidence Base for Improving Teen Depression Care
Presents findings from the Teen Depression Awareness Project, which explored how depression affects teens, the factors that influence teens' readiness to seek treatment for depression, and the barriers that teens and parents face when seeking care.
Jan 15, 2010
Journal Article
Assessment of Evidence-Based Psychotherapy Practices in Usual Care: Challenges, Promising Approaches, and Future Directions
This article comments on a special issue of Administration and Policy in Mental Health and Mental Health Services Research focused on measuring evidence-based practices in psychotherapy within usual care practice.
2010
Journal Article
Development of a Clinician Report Measure to Assess Psychotherapy for Depression in Usual Care Settings
Assessments from more than 700 clinicians helped to develop a practical tool for describing the quality of cognitive behavioral therapy, interpersonal therapy, and psychodynamic therapy.
2010
Journal Article
Usual Care Psychotherapy for Depression in a Large Managed Behavioral Health Organization
Many depressed patients are receiving recommended psychotherapy but better tools are needed to monitor and improve the quality of usual psychotherapeutic care.
2010
Journal Article
Perceived Barriers to Treatment for Adolescent Depression
Adolescent depression is common, disabling, and is associated with academic, social, behavioral, and health consequences. Teens with depression were significantly more likely to perceive barriers to care compared with nondepressed teens. Parents were less likely to report barriers than their teens; perceived stigma and concern about family member response were among the significant teen barriers. Teen perceived barriers scores were negatively associated with any use of antidepressants, use of antidepressants for at least 1 month and any psychotherapy or antidepressant use at 6 months.
Jun 1, 2009
Research Brief
Improving Mental Health Care for Returning Veterans
Identifies barriers to mental health care access for military servicemembers and veterans in community settings.
May 12, 2009
Journal Article
Mental Health Care for Iraq and Afghanistan War Veterans
Despite recent efforts to increase access to appropriate mental health care for veterans returning from conflicts in Iraq and Afghanistan, many challenges remain. These include veterans' reluctance to seek care, insufficient mental health workforce capacity and competency in evidence-based practice, and inadequate systems support for improving care. These broad challenges must be addressed across the Veterans Health Administration, the Department of Defense, and community-based care. Policy reform will require federal leadership to engage health plans, professional organizations, states, and local communities in strategies to improve veterans' access to high-quality services.
May 1, 2009
Journal Article
Future Research on Psychotherapy Practice in Usual Care
The measurement and description of psychotherapy in usual care will provide a platform for addressing other important research questions.
2009
Journal Article
The Health Value and Cost of Care for Major Depression
Describes a new approach to estimating the health value of alternative treatment patterns and applies the approach to common treatment patterns for major depression.
2009
Journal Article
Impact of Teen Depression on Academic, Social, and Physical Functioning
This study aimed to determine the impact of teen depression on peer, family, school, and physical functioning and the burden on parents.
2009
Journal Article
Improving Treatment Seeking Among Adolescents with Depression: Understanding Readiness for Treatment
To examine readiness for treatment among adolescents with depression in primary care.
2009
Journal Article
Racial/ethnic Differences in Teen and Parent Perspectives Toward Depression Treatment
Latino and African American teens had lower average scores on antidepressant knowledge and counseling knowledge than white teens.
2009
Research Brief
Invisible Wounds: Mental Health and Cognitive Care Needs of America's Returning Veterans
This research brief summarizes a comprehensive RAND study of the mental health and cognitive needs of returning servicemembers and veterans of Operations Enduring Freedom and Iraqi Freedom.
Apr 8, 2008
Report
Invisible Wounds of War: Summary and Recommendations for Addressing Psychological and Cognitive Injuries
Summarizes key findings and recommendations from Invisible Wounds of War: Psychological and Cognitive Injuries, Their Consequences, and Services to Assist Recovery (Tanielian and Jaycox [Eds.], MG-720-CCF, 2008).
Mar 30, 2008
Report
Invisible Wounds of War: Psychological and Cognitive Injuries, Their Consequences, and Services to Assist Recovery
A comprehensive study of the post-deployment health-related needs associated with post-traumatic stress disorder, major depression, and traumatic brain injury among servicemembers returning from Operations Enduring Freedom and Iraqi Freedom.
Mar 26, 2008
Journal Article
Obtaining Utility Estimates of the Health Value of Commonly Prescribed Treatments for Asthma and Depression
Comparing the costs and health value associated with alternative quality improvement efforts , this study employs expert panel methodology to elicit numerical estimates based on a 0 to 1 utility scale of the health benefit of usual treatment patterns for 2 medical conditions, depression and asthma.
2008
Research Brief
Mental Health and Substance Abuse Issues Among People with HIV: Lessons from HCSUS
This research brief describes findings from HIV Costs and Services Utilization Study surveys on the prevalence of mental health and substance abuse problems for persons with HIV, access to appropriate care, and ability to adhere to treatment.
Dec 8, 2007
Research Brief
Behavioral Health Parity: Consequences for Federal Employee Health Plans
This research brief assesses the effects of the government-required Federal Employees Health Benefits Program's provision of behavioral health benefits equal to its general health benefits on insurers and consumers' use of services and spending.
Apr 17, 2007
Journal Article
Impact of Full Mental Health and Substance Abuse Parity for Children in the Federal Employees Health Benefits Program
The Federal Employees Health Benefits Program implemented full mental health and substance abuse parity in January 2001.
Feb 1, 2007
Research Brief
Integrating Treatment for People with Co-Occurring Mental Health and Substance Abuse Disorders in Public Systems of Care
This fact sheet describes an analysis to review progress in, identify challenges for, and point to promising directions for future integrated financing arrangements and care of people with co-occurring mental health and substance abuse disorders.
Jul 12, 2006
Research Brief
Disparities in Care for HIV Patients: Results of the HCSUS Study
This research brief summarizes the findings on access to care from the HIV Costs and Services Utilization Study (HCSUS), the first comprehensive U.S. survey of health care use among a nationally representative sample of HIV-positive patients.
Apr 3, 2006
Draft
State Efforts to Improve Practice and Policy for Individuals with Co-Occurring Mental and Addictive Disorders
Assesses efforts in 23 states to improve the quality of and access to services for people with co-occurring mental and addictive disorders.
Feb 7, 2006
Journal Article
Behavioral Health Insurance Parity for Federal Employees
Implementation of parity in insurance benefits for behavioral health care can improve insurance protection without increasing total costs.
2006
Journal Article
Health Plans Respond to Parity: Managing Behavioral Health Care in the Federal Employees Health Benefits Program
The government often uses the Federal Employees Health Benefits (FEHB) Program as a model for both public and private health policy choices.
2006
Journal Article
Substance Abuse with Mental Disorders: Specialized Public Systems and Integrated Care
Separate public financing and regulation of substance (SA) abuse treatment distinct from mental health (MH) treatment preserves a focus on the special needs of those with substance abuse but creates challenges to providing appropriate care for the large number of people with co-occurring conditions.
2006
Draft
State Activities to Improve Service Delivery Systems for Individuals with Co-Occurring Mental and Addictive Disorders
State Activities to Improve Service Delivery Systems for Individuals with Co-Occurring Mental and Addictive Disorders
May 23, 2005
Journal Article
Identification of and Guidance for Problem Drinking by General Medical Providers: Results from a National Survey
Few people are queried about alcohol or drug use when they visit a GMP.
2005
Journal Article
Mental Health Status and Use of General Medical Services for Persons with Human Immunodeficiency Virus
Serious medical illness often is accompanied by psychological distress.
2005
Journal Article
Review of Treatment Recommendations for Persons with a Co-Occurring Affective or Anxiety and Substance Use Disorder
The authors review and evaluate the literature and guidelines on care for individuals with a co-occurring affective or anxiety disorder and substance use disorder.
2005
Journal Article
Selecting Performance Measures by Consensus: An Appropriate Extension of the Delphi Method?
Describes an innovative method for choosing performance measures for early psychosis treatment services.
2005
Journal Article
Abuse in the Close Relationships of People with HIV
Estimates proportion of adults with HIV involved in abusive relationships and identified factors associated with abuse perpetration and victimization.
2004
Report
The Course of Depression in Adult Outpatients: Results from the Medical Outcomes Study
The Course of Depression in Adult Outpatients: Results from the Medical Outcomes Study
2004
Report
A Cross-Lagged Model of Psychiatric Problems and Health-Related Quality of Life Among a National Sample of HIV-Positive Adults
Responses from a sample of HIV-positive adults at 2 time points approximately 8 months apart provide evidence for a reciprocal relationship between symptoms of psychiatric disorder and physical aspects of HRQOL.
2004
Journal Article
Emotional and Behavioral Consequences of Bioterrorism: Planning a Public Health Response
Relatively little attention has been paid to precisely how the public will respond to bioterrorism.
2004
Journal Article
Evaluation of Parity in the Federal Employees Health Benefits (FEHB) Program: Final Report
In the fall of 2000, the Department of Health and Human Services awarded a contract to evaluate the implementation and impact of MH/SA parity benefits in terms of access, utilization, cost, and quality of care. The findings of this evaluation are reported in the attached report.
2004
Journal Article
Psychosocial Mediators of Antiretroviral Nonadherence in HIV-positive Adults with Substance Use and Mental Health Problems
Investigates causes of nonadherence to ARV medications among patients with mental health and substance use problems.
2004
Journal Article
The Relationship Between Type of Mental Health Provider and Met and Unmet Mental Health Needs in a Nationally Representative Sample of HIV-positive Patients
Differential mental health service provision between specialists and GMPs existing in the general population also is present among persons with HIV.
2004
Journal Article
Co-occurring Psychiatric Symptoms and Drug Dependence or Heavy Drinking Among HIV-Positive People
Co-occurring psychiatric symptoms and either or both drug dependence or heavy drinking among people with HIV can reduce their quality of life and interfere with treatment adherence; therefore HIV service providers should screen for these conditions and provide appropriate services.
2003
Journal Article
Combination Antiretroviral Therapy and Improvements in Mental Health: Results from a Nationally Representative Sample of Persons Undergoing Care for HIV in the United States
ART appears to be responsible for both a treatment-specific and global improvement in the mental health of HIV+ patients.
2003
Journal Article
The Role of Schools in Meeting Community Needs During Bioterrorism
Schools will likely play a critical role in helping communities recover from a bioterrorist attack.
2003
Report
Substance Use and High-Risk Sex Among People with HIV: A Comparison Across Exposure Groups
The largest risk groups for HIV infection, men who have sex with men and injecting drug users, have high rates of substance use, but little is known about their substance use post-HIV diagnosis.
2003
Journal Article
Substance Use and Mental Health Correlates of Nonadherence to Antiretroviral Medications in a Sample of Patients with Human Immunodeficiency Virus Infection
Mental health and substance use problems are common among patients infected with HIV and may impede adherence to antiretroviral regimens.
2003
Journal Article
Underdiagnosis of Depression in HIV: Who Are We Missing?
The authors' results suggest that providers should be more attentive to diagnosing comorbid depression in HIV-infected patients.
2003
Journal Article
Use of Psychotropic Medications Among HIV-infected Patients in the United States
Describes the prevalence and pattern of use of psychotropic medications by HIV-positive patients receiving medical care in the US.
2003
Report
Access to Inpatient or Residential Substance Abuse Treatment among Homeless Adults With Alcohol or Other Drug Use Disorders
Access to Inpatient or Residential Substance Abuse Treatment among Homeless Adults With Alcohol or Other Drug Use Disorders
2002
Journal Article
Alcohol, Drug Abuse, and Mental Health Care for Uninsured and Insured Adults
To compare adults with different insurance coverage in care for alcohol, drug abuse, and mental health (ADM) problems.
2002
Journal Article
An Empirical Comparison of Substance and Alcohol Dependence Patterns in the Homeless in Madrid (Spain) and Los Angeles (CA, USA)
Alcohol and drug use continue to figure heavily in the experience of the contemporary homeless population.
2002
Journal Article
Managed Behavioral Health Care: An Instrument to Characterize Critical Elements of Public Sectors Programs
If managed behavioral health care research is to advance beyond simple case study comparisons, a well-conceptualized set of instruments is necessary.
2002
Journal Article
Predictors of Contact with Public Service Sectors Among Homeless Adults with and Without Alcohol and Other Drug Disorders
These disorders may be masking need or otherwise acting as a barrier to accessing treatment and support.
2002
Journal Article
The Prevalence of Alcohol Consumption and Heavy Drinking Among People with HIV in the United States: Results from the HIV Cost and Services Utilization Study
Alcohol consumption is common among people in care for HIV, with rates of heavy drinking almost twice those found in the general population.
2002
Periodical
RAND Review: Vol. 26, No. 2, Summer 2002
Surveys RAND research conducted since Sept. 11, 2001, that examines the dimensions of the terrorist threat and potential responses to it, and issues such as global priorities, oversees deployments, homeland security, and state and local initiatives.
2002
Journal Article
Re-Estimating the Prevalence of Psychiatric Disorders in a Nationally Representative Sample of Persons Receiving Care for HIV: Results from the HIV Cost and Services Utilization Study
Estimates of the prevalence of psychiatric disorder in the population represented by the HIV Costs and Services Utilization Study cohort.
2002
Report
Vulnerability Factors for Homelessness Associated with Substance Dependence in a Community Sample of Homeless Adults
Homeless individuals with substance dependence have many vulnerabilities beyond their substance dependence that should be dealt with in treatment or other service settings before lasting housing can be achieved.
2002
Journal Article
Brief Screening of Psychiatric Disorders Among a National Sample of HIV-positive Adults: Concordance Between the Composite International Diagnostic Interview (CIDI) and the CIDI Short Form (CIDI-SF)
The CIDI-SF provided useful information about general mental health but was less accurate for providing disorder-specific diagnoses than anticipated.
2001
Journal Article
Changes in Mental Health and Service Use After Termination of SSI Benefits
Supplemental Security Income (SSI) benefits for a substance abuse disability were terminated by federal legislation as of January 1, 1997.
2001
Journal Article
Changes in Subjective Quality of Life Among Homeless Adults Who Obtain Housing: A Prospective Examination
This study suggested that becoming independently housed may improve some aspects of quality of life for homeless people, but not others.
2001
Journal Article
Effects of Drug Abuse and Mental Disorders on Use and Type of Antiretroviral Therapy in HIV-infected Persons
Drug abuse-related factors were greater barriers to ART use in this national sample than mental disorders.
2001
Journal Article
A National Survey of Care for Persons with Co-Occurring Mental and Substance Use Disorders
Use of appropriate mental health and comprehensive substance abuse care among adults in the US with probable co-occurring disorders.
2001
Journal Article
Psychiatric Disorders and Drug Use Among Human Immunodeficiency Virus-Infected Adults in the United States
The authors enrolled a nationally representative probability sample of 2864 adults receiving care for HIV in the United States in 1996.
2001
Journal Article
Use of Mental Health and Substance Abuse Treatment Services Among Adults with HIV in the United States
Inequalities in access to care are evident, but differ among general medical, specialty mental health, and substance abuse treatment sectors.
2001
Report
Validation of the Brief Instrumental Functioning Scale in a Homeless Population
Describes the psychometric properties of a self-report questionnaire for measuring instrumental functioning in community populations, and the results of a study to validate the scale among homeless persons.
Jan 1, 2001
Journal Article
Violence Exposure Among School-Age Children in Foster Care: Relationship to Distress Symptoms
Amount and nature of violence exposure and examine the relationship between violence exposure and distress symptoms among children in foster care.
2001
Research Brief
Are People With Mental Illness Getting the Help They Need? New Findings About Parity Laws, Insurance Coverage, and Access to Care
In recent years, concerns about the adequacy of insurance benefits and quality of care for individuals with mental illness have led the majority of states and the federal government to require equal coverage for both mental health and medical conditions.
2000
Journal Article
Impact of Psychiatric Conditions on Health-Related Quality of Life in Persons with HIV Infection
Little is known about the impact of comorbid psychiatric symptoms in persons with HIV.
2000
Journal Article
Pathways to Homelessness Among the Mentally Ill
Mental illness may play a role in initiating homelessness for some, but is unlikely in and of itself to be a sufficient risk factor for homelessness.
2000
Journal Article
Quality of Life of Homeless Persons with Mental Illness: Results from the Course-of-Homelessness Study
The quality of life of homeless persons with mental illness was compared with that of homeless persons without mental illness.
2000
Report
The Design of Healthcare for Communities: A Study of Health Care Delivery for Alcohol, Drug Abuse, and Mental Health Conditions
This paper describes Healthcare for Communities (HCC), a component of the Robert Wood Johnson Foundation's Health Tracking Initiative that was designed to fill this gap for alcohol, drug abuse, and mental health care.
1999
Journal Article
Equity in Managed Care for Mental Disorders
A broader policy perspective is required to encompass concerns about fairness under managed care.
1999
Journal Article
National Probability Samples in Studies of Low-Prevalence Diseases
It is possible to design and implement a national probability sample of persons with a low-prevalence disease, even if it is stigmatized.
1999
Journal Article
Utilization of Mental Health and Substance Abuse Services Among Homeless Adults in Los Angeles
More attention must be directed at how to better deliver appropriate mental health and substance abuse services to homeless adults.
1999
Journal Article
Differential Patterns of Mental Disorders Among the Homeless in Madrid (Spain) and Los Angeles (USA)
Compare rates of mental disorders among homeless people in Madrid and Los Angeles (LA) and examine the ordering of the onset of both conditions.
1998
Research Brief
Improving Block Grant Allocation Formulas: More Refined Measures Would Shift Substance Abuse Funds to Smaller, More Rural States
Reports that the adoption of empirically derived measures of the need for services and refined measures of their costs would substantially shift block grant funds for substance abuse to smaller, more rural states.
1998
Journal Article
Measuring the Quality of Outpatient Treatment for Schizophrenia
One approach to improving care begins by developing systems that monitor quality.
1998
Journal Article
Assessing the Effectiveness of Mental Health Care in Routine Clinical Practice: Characteristics, Development, and Uses of Patient Outcomes Modules
The health care delivery system faces increasing pressure to be accountable for the historically unparalleled amount of resources it utilizes.
1997
Report
Measuring outcomes of care for substance use and mental disorders
Measuring outcomes of care for substance use and mental disorders
1997
Report
Review and Evaluation of the Substance Abuse and Mental Health Services Block Grant Allotment Formula
In 1992, Congress revised the formula that the federal government uses for distributing Block Grants to the states to provide substance abuse and mental health services.
1997
Journal Article
Enumerating Homeless People: Alternative Strategies and Their Consequences
Less inclusive sampling frames affect population estimates, but don't consistently produce biased estimates of population characteristics.
1996
Report
An Experimental Evaluation of Residential and Nonresidential Treatment for Dually Diagnosed Homeless Adults
Homeless adults with both a serious mental illness and substance dependence (N=276) were randomly assigned to: (1) a social model residential program providing integrated mental health and substance abuse treatment;...
1996
Report
The New Fiscal Federalism and the Social Safety Net: A View from California
These essays review the implications of the new fiscal federalism for the states, particularly California, from the perspective of intergovernmental relations, fiscal impact, program administration, and the consequences for the public.
1996
Report
Objective Life Circumstances and Life Satisfaction: Results from the Course of Homelessness Study
Relations between objective life circumstances and life satisfaction were examined using structural equation modeling of two waves of data obtained from homeless and mentally ill homeless participants (N=298) in the Course of Homelessness Study (COH).
1996
Journal Article
Childhood Risk Factors for Homelessness Among Homeless Adults
Using data from the Course of Homelessness Study and secondary data on the general population, the authors of this article report that problems that homeless individuals experience as adults have very clear analogs in their childhood.
1995
Draft
Evaluation of Treatment Options for the Dually Diagnosed: Final Report
Evaluation of Treatment Options for the Dually Diagnosed: Final Report
1995
Report
Implementation of residential and nonresidential treatment for the dually diagnosed homeless
Implementation of residential and nonresidential treatment for the dually diagnosed homeless
1995
Report
Severity of depression in prepaid and fee-for-service general medical and mental health specialty practices
Severity of depression in prepaid and fee-for-service general medical and mental health specialty practices
1995
Report
Subthreshold depression and depressive disorder : clinical characteristics of general medical and mental health specialty outpatients
Subthreshold depression and depressive disorder : clinical characteristics of general medical and mental health specialty outpatients
1995
Report
Do Depressed Patients in Different Treatment Settings Have Different Levels of Well-Being and Functioning?
Difficulties in the functioning and well-being of adult patients with current or past depressive disorder who visited clinicians of different specialties in health maintenance organizations, solo practices, or large multispecialty group practices were examined.
1994
Report
Prevalence of comorbid alcohol disorder and consumption in medically ill and depressed patients
Prevalence of comorbid alcohol disorder and consumption in medically ill and depressed patients
1994
Report
Treatment for the dually diagnosed homeless : program models and implementation experience : Los Angeles
Treatment for the dually diagnosed homeless : program models and implementation experience : Los Angeles
1994
Report
Outcomes for adult outpatients with depression under prepaid or fee-for-service financing
Outcomes for adult outpatients with depression under prepaid or fee-for-service financing
1993
Journal Article
Reasons for Drinking, Alcohol Use, and Alcoholism Among Mexican Americans and Non-Hispanic Whites
Estimated associations of subjective reasons for drinking with heavy drinking (HD), frequent drinking (FD), and alcohol abuse or dependence (AAOD).
Sep 1, 1992
Report
Army Families and Soldier Readiness
During the 1980s, Army families became more diverse and complex, paralleling trends in the civilian world. As these changes have developed, Army families have called for improved family and quality-of-life programs.
1992
Journal Article
Gender Differences in Depression Detection: A Comparison of Clinician Diagnosis and Standardized Assessment
Assesses the extent to which 523 medical and mental health clinicians tend to diagnose depression differentially on the basis of gender of 23,101 patients.
Dec 1, 1991
Journal Article
Caring for Depression in America: Lessons Learned from Early Findings of the Medical Outcomes Study
Data from the Medical Outcomes Study corroborate and strengthen the conclusion that depression is of considerable clinical and social importance in both outpatient medical and mental health specialty care sectors.
1991
Journal Article
How the Medical Comorbidity of Depressed Patients Differs Across Health Care Settings: Results from the Medical Outcomes Study
Clinicians in all health care settings must be prepared to encounter chronic medical conditions and complaints in the depressed patients who visit them.
1991
Journal Article
Alcohol Use and Depressive Symptoms Among Mexican Americans and Non-Hispanic Whites
This study assessed levels of depressive symptomatology in a household probability sample of Mexico-born and U.S.-born Mexican Americans.
1990
Journal Article
Immigration, Stress, and Depressive Symptoms in a Mexican-American Community
This study assessed levels of depressive symptomatology in a household probability sample of Mexico-born (N = 706) and U.
1990
Journal Article
Acculturation and the Probability of Use of Health Services by Mexican Americans
How does level of acculturation affect the probability that Mexican Americans use general health, mental health, and human social services? We studied this question using data from a general population sample of Mexican Americans.
1989
Journal Article
Affective, Substance Use, and Anxiety Disorders in Persons with Arthritis, Diabetes, Heart Disease, High Blood Pressure, or Chronic Lung Conditions
Persons with current arthritis, heart disease, or high blood pressure had a significantly increased adjusted prevalence of recent anxiety disorder.
1989
Journal Article
Chronic Medical Conditions in a Sample of the General Population with Anxiety, Affective, and Substance Use Disorders
The authors studied the prevalence of eight chronic medical conditions in an adult population sample with and without psychiatric disorders.
1989
Report
The Functioning and Well-Being of Depressed Patients: Results from the Medical Outcomes Study
This Note describes the functioning and well-being of patients with depression, relative to patients with chronic medical conditions or no chronic conditions.
1989
Journal Article
Resistance to Sexual Assault: Who Resists and What Happens?
To determine who resists sexual assault and what happens, data examined from a probability sample of 3,132 adult community residents of Los Angeles.
1989
Journal Article
Alcoholism Among Homeless Adults in the Inner City of Los Angeles
Both lifetime and current prevalence of alcoholism (as measured by the NIMH Diagnostic Interview Schedule) was higher among homeless individuals.
1988
Journal Article
The Epidemiology of Obsessive-Compulsive Disorder in Five US Communities
The prevalence of obsessive-compulsive disorder was measured in five US communities among more than 18,500 persons in residential settings.
1988
Journal Article
The Prevalence of Specific Psychiatric Disorders Among Homeless Individuals in the Inner City of Los Angeles
Lifetime and current prevalence of Diagnostic Interview Schedule/DSM-III disorders were determined for a probability sample of homeless adults in the Skid Row area of Los Angeles.
1988
Journal Article
Psychiatric Disorder and Limitations in Physical Functioning in a Sample of the Los Angeles General Population
The authors examined relationships between psychiatric disorder and perceived general health and physical functioning from data obtained from interviews with 2,554 non-Hispanic whites and Mexican-Americans in Los Angeles.
1988
Report
Review of California's Program for the Homeless Mentally Disabled: Executive Summary
This report is an executive summary of RAND/R-3631-CDMH.
1988
Report
Review of California's Program for the Homeless Mentally Disabled
Assesses the effectiveness of California's recent Program for the Homeless Mentally Disabled, determines the accountability of its funds, and describes the demographic and mental disorder characteristics of those it serves.
1988
Journal Article
Sexual Assault and Mental Disorders in a Community Population
Sexual assault predicted later onset of major depressive episodes, substance use disorders, and anxiety disorders.
1988
Journal Article
Sexual Assault History and Use of Health and Mental Health Services
A history of sexual assault may be associated with increased current use of mental health and medical services because of the psychologically and physically disruptive consequences of assault.
1988
Journal Article
The Prevalence of Childhood Sexual Assault: The Los Angeles Epidemiologic Catchment Area Project
This study reports childhood sexual assault data collected as part of a community-based population study on mental health.
1987
Journal Article
Six-month Prevalence of Specific Psychiatric Disorders Among Mexican Americans and Non-Hispanic Whites in Los Angeles
The current prevalence of DSM-III psychiatric disorders was assessed using the Diagnostic Interview Schedule (DIS) as part of a Los Angeles household population survey.
1987
Report
Validity of the H-HANES Acculturation Measure for Mexican Americans
The validity of the brief (eight-item) acculturation measure fielded as part of the Hispanic Health and Nutrition Examination Survey (H-HANES) was examined using data from an independent household sample of Mexican Americans in Los Angeles.
1987