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Psychiatr Serv. 2009 May;60(5):646-54. doi: 10.1176/appi.ps.60.5.646.

Substance use, symptom, and employment outcomes of persons with a workplace mandate for chemical dependency treatment.

Author information

1
Department of Psychiatry, University of California, San Francisco, 401 Parnassus Ave., Box F-0984, San Francisco, CA 94143, USA. constance.weisner@kp.org

Abstract

OBJECTIVE:

This study examined the role of workplace mandates to chemical dependency treatment in treatment adherence, alcohol and drug abstinence, severity of employment problems, and severity of psychiatric problems.

METHODS:

The sample included 448 employed members of a private, nonprofit U.S. managed care health plan who entered chemical dependency treatment with a workplace mandate (N=75) or without one (N=373); 405 of these individuals were followed up at one year (N=70 and N=335, respectively), and 362 participated in a five-year follow up (N=60 and N=302, respectively). Propensity scores predicting receipt of a workplace mandate were calculated. Logistic regression and ordinary least-squares regression were used to predict length of stay in chemical dependency treatment, alcohol and drug abstinence, and psychiatric and employment problem severity at one and five years.

RESULTS:

Overall, participants with a workplace mandate had one- and five-year outcomes similar to those without such a mandate. Having a workplace mandate also predicted longer treatment stays and improvement in employment problems. When other factors related to outcomes were controlled for, having a workplace mandate predicted abstinence at one year, with length of stay as a mediating variable.

CONCLUSIONS:

Workplace mandates can be an effective mechanism for improving work performance and other outcomes. Study participants who had a workplace mandate were more likely than those who did not have a workplace mandate to be abstinent at follow-up, and they did as well in treatment, both short and long term. Pressure from the workplace likely gets people to treatment earlier and provides incentives for treatment adherence.

PMID:
19411353
PMCID:
PMC2878200
DOI:
10.1176/ps.2009.60.5.646
[Indexed for MEDLINE]
Free PMC Article
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