MEASURING
RECOVERY FROM
SUBSTANCE USE OR
MENTAL DISORDERS
WORKSHOP SUMMARY
Krisztina Marton, Rapporteur
Committee on National Statistics and
Board on Behavioral, Cognitive, and Sensory Sciences,
Division of Behavioral and Social Sciences and Education
and
Board on Health Sciences Policy
Health and Medicine Division
THE NATIONAL ACADEMIES PRESS
Washington, DC
www.nap.edu
THE NATIONAL ACADEMIES PRESS500 Fifth Street, NWWashington, DC 20001
This activity was supported by Contract No. HHSP233201400020B/HHSP23337002 between the National Academy of Sciences and the U.S. Department of Health and Human Services. Support of the work of the Committee on National Statistics is provided by a consortium of federal agencies through a grant from the National Science Foundation (No. SES-1024012). Any opinions, findings, conclusions, or recommendations expressed in this publication do not necessarily reflect the views of any organization or agency that provided support for the project.
International Standard Book Number-13: 978-0-309-44721-8
International Standard Book Number-10: 0-309-44721-6
Digital Object Identifier: 10.17226/23589
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Suggested citation: National Academies of Sciences, Engineering, and Medicine. (2016). Measuring Recovery from Substance Use or Mental Disorders: Workshop Summary. K. Marton, Rapporteur. Committee on National Statistics and Board on Behavioral, Cognitive, and Sensory Sciences, Division of Behavioral and Social Sciences and Education. Board on Health Sciences Policy, Health and Medicine Division. Washington, DC: The National Academies Press. doi: 10.17226/23589.
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STEERING COMMITTEE FOR THE WORKSHOP ON INTEGRATING NEW MEASURES OF RECOVERY FROM SUBSTANCE USE AND MENTAL DISORDERS INTO THE SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION’S DATA COLLECTION PROGRAMS
HORTENSIA AMARO (Chair), School of Social Work, University of Southern California
WILSON COMPTON, National Institute on Drug Abuse, National Institutes of Health
SHERRY GLIED, Robert F. Wagner Graduate School of Public Service, New York University
CHRISTINE GRELLA, David Geffen School of Medicine, University of California, Los Angeles
JAMES JACKSON, Institute for Social Research, University of Michigan
KRISZTINA MARTON, Study Director
JEANNE C. RIVARD, Senior Program Officer
MICHAEL SIRI, Program Associate
COMMITTEE ON NATIONAL STATISTICS
LAWRENCE D. BROWN (Chair), Department of Statistics, The Wharton School, University of Pennsylvania
JOHN M. ABOWD, School of Industrial and Labor Relations, Cornell University
FRANCINE BLAU, Department of Economics, Cornell University
MARY ELLEN BOCK, Department of Statistics (emerita), Purdue University
MICHAEL CHERNEW, Department of Health Care Policy, Harvard Medical School
DONALD DILLMAN, Social and Economic Sciences Research Center, Washington State University
CONSTANTINE GATSONIS, Department of Biostatistics and Center for Statistical Sciences, Brown University
JAMES S. HOUSE, Survey Research Center, Institute for Social Research, University of Michigan
MICHAEL HOUT, Department of Sociology, New York University
THOMAS MESENBOURG, U.S. Census Bureau (retired)
SUSAN MURPHY, Department of Statistics and Institute for Social Research, University of Michigan
SARAH NUSSER, Office of the Vice President for Research, Iowa State University
COLM O’MUIRCHEARTAIGH, Harris School of Public Policy Studies, University of Chicago
RUTH PETERSON, Criminal Justice Research Center, Ohio State University
ROBERTO RIGOBON, Sloan School of Management, Massachusetts Institute of Technology
EDWARD SHORTLIFFE, Department of Biomedical Informatics, Columbia University and Arizona State University
CONSTANCE F. CITRO, Director
BRIAN HARRIS-KOJETIN, Deputy Director
BOARD ON BEHAVIORAL, COGNITIVE, AND SENSORY SCIENCES
SUSAN T. FISKE (Chair), Department of Psychology and Woodrow Wilson School of Public and International Affairs, Princeton University
LAURA L. CARSTENSEN, Department of Psychology, Stanford University
JENNIFER S. COLE, Department of Linguistics, University of Illinois at Urbana–Champaign
JUDY R. DUBNO, Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina
ROBERT L. GOLDSTONE, Department of Psychological and Brain Sciences, Indiana University
DANIEL R. ILGEN, Department of Psychology, Michigan State University
NINA G. JABLONSKI, Department of Anthropology, Pennsylvania State University
JAMES S. JACKSON, Institute for Social Research, University of Michigan
NANCY G. KANWISHER, Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology
JANICE KIECOLT-GLASER, Department of Psychology, Ohio State University College of Medicine
WILLIAM C. MAURER, School of Social Sciences, University of California, Irvine
JOHN MONAHAN, School of Law, University of Virginia
STEVEN E. PETERSEN, Department of Neurology and Neurological Surgery, Washington University School of Medicine, St. Louis
DANA M. SMALL, Department of Psychiatry, Yale University School of Medicine
TIMOTHY J. STRAUMAN, Department of Psychology and Neuroscience, Duke University
ALLAN R. WAGNER, Department of Psychology, Yale University
JEREMY M. WOLFE, Brigham and Women’s Hospital and Departments of Ophthalmology and Radiology, Harvard Medical School
BARBARA A. WANCHISEN, Director
BOARD ON HEALTH SCIENCES POLICY
JEFFREY KAHN (Chair), Department of Health Policy & Management and Berman Institute of Bioethics, Johns Hopkins University
ELI Y. ADASHI, The Warren Alpert Medical School, Brown University
WYLIE BURKE, Department of Bioethics and Humanities, University of Washington
R.A. CHARO, Law School and the Department of Medical History and Bioethics, University of Wisconsin–Madison
LINDA H. CLEVER, California Pacific Medical Center, San Francisco
BARRY S. COLLER, Allen and Frances Adler Laboratory of Blood and Vascular Biology, Rockefeller University
LEWIS R. GOLDFRANK, Ronald O. Perelman Department of Emergency Medicine, New York University Langone Medical Center
BERNARD A. HARRIS, JR., Vesalius Ventures, Houston, TX
MARTHA N. HILL, Department of Community-Public Health, Johns Hopkins University School of Nursing
STEVEN E. HYMAN, Stanley Center for Psychiatric Research, Broad Institute, Cambridge, MA
ALAN M. JETTE, Department of Health Law, Policy & Management, Boston University School of Public Health
PATRICIA A. KING, Georgetown University Law Center
STORY C. LANDIS, National Institute of Neurological Disorders and Stroke, U.S. Department of Health and Human Services
HARRY T. ORR, Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis
UMAIR A. SHAH, Harris County Public Health and Environmental Services, Houston, TX
ROBYN STONE, LeadingAge, Washington, DC
SHARON TERRY, Genetic Alliance, Washington, DC
REED V. TUCKSON, Tuckson Health Connections, LLC, Sandy Springs, GA
ANDREW M. POPE, Director
Acknowledgment of Reviewers
This workshop summary has been reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise, in accordance with procedures approved by the Report Review Committee of the National Academies of Sciences, Engineering, and Medicine. The purpose of this independent review is to provide candid and critical comments that will assist the institution in making its published workshop summary as sound as possible and to ensure that it meets institutional standards for objectivity, evidence, and responsiveness to the charge. The review comments and draft manuscript remain confidential to protect the integrity of the process.
We thank the following individuals for their review of this workshop summary: Christine Grella, Integrated Substance Abuse Programs, University of California, Los Angeles; John F. Kelly, Department of Psychiatry, Harvard Medical School and Massachusetts General Hospital Recovery Research Institute and Massachusetts General Hospital Addiction Recovery Management Service; and Mark Salzer, Department of Rehabilitation Sciences and Collaborative on Community Inclusion of Individuals with Psychiatric Disabilities, Temple University.
Although the reviewers listed above provided many constructive comments and suggestions, they were not asked to endorse the content of the summary nor did they see the final draft before its release. The review of this workshop summary was overseen by Susan A. Murphy, Department of Statistics and Institute for Social Research, University of Michi-
gan. Appointed by the National Academies of Sciences, Engineering, and Medicine, she was responsible for making certain that an independent examination of this workshop summary was carried out in accordance with institutional procedures and that all review comments were carefully considered. Responsibility for the final content of this summary rests entirely with the rapporteur and the institution.
Contents
2 POLICY CONTEXT AND KEY CONCEPTS
Policy Context of Measuring Recovery from Substance Use
Policy Context of Measuring Recovery from Mental Disorders
3 SAMHSA’S DEFINITION OF RECOVERY
4 DEFINING AND OPERATIONALIZING RECOVERY FROM SUBSTANCE USE
Definitions of Recovery from Substance Use and Implications for Measurement
The Meaning of Recovery for Those Who Self-Identify as “in Recovery” from Substance Use
5 DEFINING AND OPERATIONALIZING RECOVERY FROM MENTAL DISORDERS
Definitions of Recovery from Mental Disorders and Implications for Measurement
The Role of Positive Mental Health in Operationalizing Recovery