September 2, 2010

Substance Abuse Treatment Facilities Affiliated with a Religious Organization

Addressing the substance use treatment needs of a diverse population necessitates a diverse system of care with treatment options designed to meet the unique needs and preferences of clients. The beneficial role that faith and spirituality play in the programs designed to treat and promote recovery from substance abuse has long been acknowledged, making faith-based organizations an important component of the treatment system.¹ Faith-based organizations have a long history of providing services to individuals within their communities, and the last decade has brought increased collaboration between faith-based organizations and the Federal Government. The Office of Faith-Based and Community Initiatives established in 2001 and its successor, the Office of Faith-Based and Neighborhood Partnerships established in 2009, emphasize and facilitate the partnership between faith-based organizations and the government in addressing societal problems. Understanding the characteristics of faith-based substance abuse treatment facilities provides community leaders and policy makers with a more complete picture of the treatment services available in their communities.

Facility Characteristics

All faith-based facilities were privately operated, either by a non-profit or for-profit organization. Faith-based facilities were more likely than non-faith-based facilities to be operated by a private non-profit organization (93.9 vs. 63.1 percent), and 6 times less likely to be operated by a private for-profit organization (6.1 vs. 36.9 percent).

Faith-based facilities served fewer clients on a typical day than non-faith-based facilities. On the survey reference date of March 31, 2008, there was an average of 74 clients enrolled in faith-based facilities compared with an average of 88 clients enrolled in non-faith-based facilities.²

When examined by region, 33.0 percent of faith-based facilities were located in the Midwest. Smaller proportions were located in the West (23.7 percent), South (21.9 percent), and Northeast (21.3 percent).

Primary Focus and Type of Care

N-SSATS collects information on the primary focus of the treatment provided by facilities, and categorizes this focus into five main types—substance abuse treatment services, mental health services, mix of mental health and substance abuse treatment services (neither is primary), general health care, and other. Faith-based facilities were more likely than non-faith-based facilities to focus primarily on providing substance abuse treatment services (69.3 vs. 63.7 percent) and were less likely to provide a mix of mental health and substance abuse treatment (21.8 vs. 28.9 percent) (Figure 1).

N-SSATS also collects information on the type of substance abuse treatment offered by facilities. Some facilities provide one type of care while others provide a combination of types. Outpatient-only treatment was the most common type of care provided by faith-based facilities, although they were less likely than non-faith-based facilities to provide only this type of care (49.0 vs. 71.6 percent). Faith-based facilities were almost twice as likely as non-faith-based facilities to offer non-hospital residential treatment only (34.9 vs. 18.8 percent) or both outpatient and non-hospital residential treatment (15.2 vs. 8.4 percent).

Services Offered

Faith-based facilities provided a range of assessment and pre-treatment services that were generally similar to those provided by non-faith-based facilities. Most faith-based facilities offered screening for substance abuse (88.7 percent) and comprehensive substance abuse assessment or diagnosis (82.0 percent), and more than half provided community outreach (61.8 percent) (Table 1). Faith-based facilities were less likely than non-faith-based facilities to provide screening for mental health disorders (52.3 vs. 60.4 percent) or comprehensive mental health assessment or diagnosis (33.7 vs. 40.3 percent).

Similar proportions of faith-based and non-faith-based facilities offered testing services. Most faith-based facilities offered drug or alcohol urine screening (81.9 percent), and the majority offered breathalyzer or other blood alcohol testing (56.9 percent). A relatively small percentage provided communicable disease testing, ranging from 12.9 percent that provided STD testing to 29.2 percent that provided TB screening.

Most faith-based facilities offered transitional and ancillary services such as substance abuse education (92.8 percent), discharge planning (87.6 percent), aftercare or continuing care (76.3 percent), case management (75.4 percent), and social skills development (71.5 percent) (Table 2). Faith-based facilities were more likely than non-faith-based facilities to offer self-help groups (57.4 vs. 45.0 percent), assistance with obtaining social services (56.2 vs. 50.8 percent), mentoring/peer support (56.0 vs. 47.4 percent), transportation assistance (47.6 vs. 35.2 percent), and employment counseling or training (47.4 vs. 35.8 percent). In addition to these ancillary or transitional services, faith-based facilities were more than twice as likely as non-faith-based facilities to provide a halfway house or other transitional housing (24.1 vs. 10.4 percent).

About one quarter (28.1 percent) of all faith-based facilities provided pharmacotherapies, or medication-assisted treatment, compared with 40.2 percent of non-faith-based facilities. Among both facility types, medication for the treatment of psychiatric disorders was the most commonly provided pharmacotherapy. However, faith-based facilities were less likely than non-faith-based facilities to provide this service (21.3 vs. 27.4 percent). They were also less likely to operate a certified Opioid Treatment Program (OTP) (1.1 vs. 8.4 percent).

Counseling and Therapeutic Approaches

Similar proportions of faith-based and non-faith-based facilities offered specific types of counseling. Most faith-based facilities offered individual (97.0 percent) and group (91.5 percent) counseling, and the majority offered family counseling (72.5 percent). Marital or couples counseling was offered by nearly half of faith-based facilities (45.2 percent).

N-SSATS collects information on the frequency that specific clinical or therapeutic approaches are offered by substance abuse treatment facilities. Similar proportions of faith-based and non-faith-based facilities offered most of these clinical or therapeutic approaches "always" or "often." However, faith-based facilities were more likely than non-faith-based facilities to "always" or "often" use the 12-step facilitation (64.0 vs. 56.0 percent) or anger management (54.6 vs. 40.1 percent) and less likely to use motivational interviewing (49.3 vs. 54.6 percent) (Table 3).

Programs or Groups for Specific Client Types

Specialty programs are designed to serve the needs of specific populations in treatment, such as adolescents or criminal justice clients. Nearly three quarters (73.6 percent) of faith-based facilities offered at least one special program or group to serve a specific client type; the majority offered a specially designed program or group for adolescents (61.2 percent) (Table 4). Faith-based facilities were more likely than non-faith-based facilities to offer a special program or group for adult women (49.1 vs. 37.6 percent) or adult men (40.8 vs. 30.2 percent).

Payment

Faith-based facilities were more likely than non-faith-based facilities to offer treatment at no charge to clients who could not afford to pay (59.4 vs. 45.2 percent). They were also more likely to provide free treatment to all clients (10.6 vs. 3.4 percent) (Figure 2). Most faith-based facilities accepted cash or self-payments (83.2 percent); less than half accepted private health insurance (47.3 percent) or Medicaid (45.9 percent), and less than one third accepted other State-financed health insurance (30.6 percent), Medicare (24.5 percent), Access to Recovery (ATR) vouchers³ (24.2 percent), or Federal military insurance such as TRICARE or Champ VA (22.0 percent).

Discussion

Faith-based facilities are an important component of the substance abuse treatment system. Like other facilities, those that are faith-based offer a wide array of services and programs designed to support recovery and address the needs of substance abuse clients. However, faith-based and non-faith-based facilities did differ in a number of ways. Of particular note, faith-based facilities were more likely than non-faith-based facilities to offer free treatment to persons who could not afford the costs associated with substance abuse treatment and were also more likely to offer free treatment to all clients. Thus, faith-based facilities may help to fill gaps in access to treatment by providing services to individuals who otherwise might not be able to obtain them. Policymakers and treatment advocates need to ensure that communities are aware of this and that resources are available to faith-based facilities so they can continue to provide free and low-cost care.

It is also important to improve communication about specific services that are offered because faith-based facilities were more likely than non-faith-based facilities to offer some types of services (such as providing halfway or transitional housing and self-help groups) and less likely to offer other types of services (such as screening for or comprehensive assessment/diagnosis of mental health disorders). Information on the services offered by faith-based facilities, as well as the similarities and differences between faith-based and non-faith-based facilities, may help persons seeking treatment to make more informed decisions regarding their care and help health professionals to make referrals to treatment.

End Notes

Suggested Citation

Substance Abuse and Mental Health Services Administration, Office of Applied Studies. (September 2, 2010). The N-SSATS Report: Substance Abuse Treatment Facilities Affiliated with a Religious Organization. Rockville, MD.

The N-SSATS Report is published periodically by the Office of Applied Studies, Substance Abuse and Mental Health Services Administration (SAMHSA). All material appearing in this report is in the public domain and may be reproduced or copied without permission from SAMHSA. Additional copies of this report or other reports from the Office of Applied Studies are available online: http://oas.samhsa.gov. Citation of the source is appreciated. For questions about this report, e-mail: shortreports@samhsa.hhs.gov.

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