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“If you asked me on a scale of 1 to 10, where I would place Skyland Trail in my recovery, I would give it a 15.”

– Bill L.

Treatment Outcomes

Skyland Trail is a trailblazer in the area of outcomes research, which is an integral part of our evidence-based treatment model. Our robust outcomes and research program employs evaluative instruments considered to be the gold standards in the mental health field to measure the effectiveness of our treatment programs. Outcome data from 2008 through 2017 confirm that our unique integrated, whole person approach helps our clients grow, recover, and reclaim their lives. People who complete the treatment program at Skyland Trail return to their communities with reduced symptoms and improved skills to pursue more independent and productive lives.

When clients begin treatment at Skyland Trail, they complete tests measuring their symptom severity, attitude toward medication adherence, hope for the future, level of functioning, senses of self efficacy and relationships with others, and physical health. We measure those indicators again when they complete their treatment. We supplement these measurements with annual satisfaction surveys.

Specialized instruments based on diagnoses and symptoms provide a more detailed picture of the effectiveness of specific treatment programs for bipolar illness, major depression, schizophrenia, and anxiety.

Who We Treat

Client diagnosesWe treat adults ages 18 and older with a primary psychiatric diagnosis. In 2017,  58% of clients had 3 or more co-occurring diagnoses – including anxiety disorders, substance use disorders, and personality disorders – in addition to a mood or thought disorder. Admissions criteria >

2017 Key Outcomes

  • 88% of all clients experienced a statistically significant improvement in their attitude toward activities of daily living & overall functioning
  • 74% of clients with anxiety experienced statistically significant improvement in control of anxiety
  • 92% of clients left treatment with a positive attitude about taking psychiatric medication
  • 76% of all clients experienced a statistically significant improvement in feelings of hopelessness
  • 90% of clients with severe symptoms of depression experienced clinically significant reduction
  • 93% of clients who had clinically meaningful episodes of mania showed no symptoms of clinically meaningful mania at discharge

Publications: 2017 Outcomes Report

Patient Complexity

Skyland Trail has specialized in treating complex patients for many years. Many patients enroll in the residential treatment program after participating in other outpatient or inpatient therapeutic programs without results.

In 2017, Skyland Trail treated a large number of young adult patients ages 18 to 25 with a complex constellation of co-occurring disorders: a mood disorder, borderline personality disorder, and a substance misuse disorder.

Patients in this category had outcomes similar to the broader patient population and experienced significant improvement in symptoms, functionality, and hopeful thinking.

Of complex clients ages 18-25 with a mood disorder and a substance use disorder, or a mood disorder and a personality disorder:

  • 46% who had significant and systemic impairment at admission were full functioning by graduation
  • 93% improved hopefulness
  • 86% improved attitude toward taking psychiatric medications

Improved Medication Adherence

Scores on the Medication Attitude Inventory (MAI) range from 0 to 10, with higher scores indicating more positive attitudes towards medication use and medication adherence. On average, clients in  2017 experienced statistically significant improvement with an average attitude score of 4.02 at admission to a 6.69 at discharge.

Attitude toward taking psychiatric medications is a surrogate measure for medication adherence. Medication adherence is one of the best predictors of sustained recovery.

Medication Attitude Inventory 2017

Medication Attitude Inventory 2017

Improved Functioning

In 2017, patients consistently showed statistically significant functional improvement as measured by the BASIS-32. Comprised of 5 subscales, the BASIS-32 contains an overall average score ranging from 0 to 4, with lower scores indicating greater levels of functioning in daily life, interpersonal relationships, impulsivity, psychosis, depression, and anxiety.

Clients as a group showed significant impairment at admission, and low-moderate impairment (and in many cases, no impairment) at discharge.

Skyland Trail's Improved Functioning Outcome Report 2017

Increased Hopeful Thinking

In 2017, clients continued to experience a statistically significant decrease in feelings of hopelessness, t(196)=4.77, p =0.000. This finding indicates that, on average, individuals improved from feeling very hopeless at admission to having hopeful future expectations at discharge.

Hope for one’s future is one of the best predictors of continued adherence to a recovery plan. Human beings are much more than constellations of symptoms, thoughts and behaviors. Hopefulness, social interconnectivity, and a sense of self efficacy define recovery and what it means to be mentally well.

Beck Hopelessness Scale Scores 2017

Beck Hopelessness Scale Scores 2017

Research & Publications

Poster: Screening, Delivering and Measuring Outcomes For Cognitive Remediation Training in a Private Non-Profit Community Mental Health Setting
Presented: IPS, The Mental Health Services Conference 2017
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Article: Measuring and Facilitating Client Engagement with Financial Incentives: Implications for Improving Clinical Outcomes in a Mental Health Setting
Community Mental Health Journal 2016;9: 1-9
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Article: Systematic Study of Structured Diagnostic Procedures in Outpatient Psychiatric Rehabilitation: A Three-year, Three-cohort Study of the Stability of Psychiatric Diagnoses
Innovations in Clinical Neuroscience 2013;10(5-6):14-19
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Poster: A Model Wellness Intervention Aimed at Reducing Cardiometabolic Syndrome Risk Associated with Psychotropic Medications
Presented: APA Annual Meeting 2015
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Poster: A Longitudinal Analysis of Patients’ Perceptions of Life Events After Discharge from Community Mental Health Services
Presented: APA Annual Meeting 2014
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Poster: Engagement Trajectories in Community-Based Mental Health Service Delivery: The Role of Financial Incentives
Presented: APA Institute on Psychiatric Services Annual Meeting 2013
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Poster: Engagement Trajectories in Community-Based Mental Health Service Delivery: The Role of Financial Incentives
Presented: APA Annual Meeting 2013
View >