Outcomes
Annually, Skyland Trail monitors key client demographic and clinical indicators to assess the impact of treatment and program effectiveness. Demographically, data is recorded on client age and age distribution, gender, diagnosis, and length of stay. Demographic changes in our client population are important to recognize and respond to as this often dictates treatment.
Skyland Trail measures clinical changes in our patients' symptom severity, attitude toward medication adherence, hope for their futures, and level of functioning. In looking at clinical indicators, favorable responses to treatment are reflected by statistically significant changes on various assessment scales between admission and discharge.
Medical Director Raymond J. Kotwicki, MD, MPH and the clinical team created and instituted a new clinical model of care in June 2007 called the Skyland Trail Integrative Recovery Model. Between 2007-2010 using the new clinical model, outcome data showed statistically and clinically significant improvement on many levels. We attribute these significant gains to the individualized, evidence-based, respectful model of care offered, as well as the expertise afforded to patients in services by our outstanding, dedicated clinical staff. More information on the innovative model of services provided appears below.
Click here to read 2007-2010 Outcomes and Demographics Report
2010 Client Outcomes and Demographics
BACKGROUND DEMOGRAPHICS
Age/Gender
Year 2010 totaled more admissions to any level of service at Skyland Trail than ever before in our 21-year history (N=211). Of all patients who both admitted and discharged within the year (N=165) close to fifty percent were women. The average age at admission for women was 35 years; 33 for men. Reflecting a trend Skyland Trail has experienced over the past several years, 35 percent of all admissions were aged 18-25.
Diagnosis
Nearly three-quarters of patients treated at Skyland Trail in 2010 had a primary mood disorder (either major depression or bipolar affective disorder). Of these clients, many (nearly 40 percent) also had a history of substance misuse and benefited from our dual-diagnosis treatment track. That team is headed by a board-certified addiction medicine physician. Twenty percent of patients treated in 2010 had a primary thought disorder (schizophrenia or schizoaffective disorder). These patients employed cognitive remediation and cognitive behavioral therapies in addition to pharmacotherapy to work on their recovery goals. Life-skills training such as social skills, hygiene, nutrition, exercise, and vocational services are part of all individuals' recovery plans.
Length of Stay
Recent economic factors have driven the average lengths of stay shorter since 2007; however, various opportunities including our need-based Financial Aid Program, in-house insurance review specialists, and various financing options allow patients to complete their recovery programs while prudently utilizing health care and economic resources. Engagement in programs positively influences overall outcomes, and is also measured weekly and used as an incentive to maximize the benefit of services offered at Skyland Trail.
SYMPTOMOLOGY
Behavior and Symptom Identification Scale (BASIS-32)
The Behavior and Symptom Identification Scale-32 (BASIS-32) is a 32-item client selfreport inventory that measures reduction in feelings of anxiety, depression, impulsivity, and psychosis as well as improvement in relationships with others, in performing daily activities and in feelings of hopelessness and depression. A decreasing score from admission to discharge is desirable.
In 2010, clients with all diagnoses reported statistically significant improvements in many aspects of life, including symptoms of mental illness like depression and anxiety, ability to complete daily living skills, improved relationships, and decreased impulsivity.
These outcomes speak to the evidence-based Skyland Trail Integrated Medical Recovery Model of care which was developed using current best medical practices. Individualized treatment plans are carefully crafted based on individuals' diagnoses, perceived goals, and thorough analyses of medical research literature that best matches specific therapies with patients' circumstances. In total, all patients who completed their recovery programs at Skyland Trail in 2010 improved 63 percent in symptomatic and functional domains measured by the BASIS-32.
