An outcome study of Missouri's CSTAR alcohol and drug abuse programs.

The Comprehensive Substance Abuse Treatment and Rehabilitation (CSTAR) program is described, and a study of its services is presented. The CSTAR program is a community program with wrap-around services and intensive case management. Eleven domains typically affected by substance abuse were measured, plus satisfaction with treatment services. A retrospective study of 280 clients at 10 facilities was done, and results analyzed separately by General Programs. Women with Children programs, and Adolescent programs. A small sample of clients who were early in their treatment was re-interviewed 90 days later. Data were also examined according to length of stay in the program. Results were consistently positive, and increased with length of time in the program.

Maintaining the confidentiality of computerized mental health outcome data.

The emergence of managed behavioral health care has increased the value of data describing outcomes of mental health treatment. At the same time, increased development of the national information infrastructure and other computer linkage systems has facilitated the flow of information among a wide network of data systems. These two developments create a dynamic tension between the need to share information and the need to protect the privacy of mental health clients and the confidentiality of their computerized records. This problem is exacerbated by the cost associated with potential solutions. Unfortunately, policy development in this area has lagged behind rapid developments in technology. The mental health administrator must balance the three components of this conflict (the increasing need for information transfer, the protection of confidentiality, and cost) without a great deal of guidance. This article offers recommendations that may help the mental health administrator manage this conflict.