Literature Collection

OBJECTIVE: To evaluate the Mental Health and Primary Care Partnership (MaP) pilot program which operated in a metropolitan Melbourne setting in 2020. METHOD: Data collection included: surveys, interviews, file audits, and an evaluation of routinely collected data, with MaP consumers, their carers, GPs, Practice Managers and Nurses located in Boroondara, and MaP and Aged Person's Mental Health Service staff. RESULTS: Thirty-five consumers aged between 66 and 101 years old (of whom 63% were female) received support from the MaP program throughout its 12-month operation. Statistically significant improvements in outcome measures assessing for psychological distress and symptoms of mental illness were observed. Strengths of the program included the single referral pathway and the provision of services for those not meeting criteria to access tertiary mental health support. Consumers and clinicians made recommendations for service improvement including provision of a longer duration of care to consumers and greater integration of community and primary care. CONCLUSIONS: It is hoped that the learnings from the MaP pilot program can be used to guide future program development.

As treatment expansion in the opioid epidemic continues, it is important to examine how the makeup of individuals with opioid use disorder (OUD) is evolving. Treatment programs are increasingly utilizing buprenorphine, an effective OUD medication. This exploratory study examines sex and gender differences in psychosocial, clinical and substance use treatment characteristics of a clinical population in outpatient medication treatment for OUD with buprenorphine. This is a secondary data analysis from a cross-sectional survey study with retrospective medical record review conducted with patients recruited from an office-based opioid treatment clinic between July-September 2019. Participants on buprenorphine for at least 28 days at time of survey completion were included (n=133). Differences between men and women were explored with Pearson χ(2) and Fisher's Exact Tests for categorical variables and T-Tests for continuous variables. The sample was 55.6% women and nearly three-fourths Black (70.7%). Mean days in current treatment episode was 431.6 (SD=244.82). Women were younger and more likely to be unemployed, identify as a sexual minority, and live alone with children than men. More women than men had a psychiatric comorbidity. Women reported more prescription opioid misuse while men had more heroin only opioid use. More men reported comorbid alcohol use and a history of drug overdose. One-third of participants reported recent discrimination in a healthcare setting due to substance use. As buprenorphine-based outpatient treatment programs continue to expand, present study findings support evaluation of the unique needs of men and women in order to better tailor OUD-related services and improve treatment outcomes.