ATLANTA, GA – Skyland Trail recently published the 2020 Outcomes Research Report. Outcomes research is an integral part of Skyland Trail’s evidence-based treatment model and measurement-based care provided to adult and adolescent clients in the psychiatric residential treatment and day treatment programs in Atlanta.

Patients complete standardized clinical assessments during the admissions process that measure their symptoms (including diagnosis-specific symptoms), attitude toward medication and treatment, hope for the future, level of functioning, sense of self-efficacy and relationships with others, and physical health. These indicators are also measured throughout treatment and when clients complete their treatment at Skyland Trail.

Key overall client outcome measures include:

• 89% of all patients experienced a clinically significant improvement in functionality, symptoms, and social relationships¹
• 85% of patients with anxiety experienced clinically significant improvement in control of anxiety⁶
• 86% of all patients experienced a clinically significant improvement in hope²
• 88% of clients with very severe and severe symptoms of depression experienced clinically significant reduction in symptoms⁴
• 100% of clients who had clinically meaningful episodes of mania showed no symptoms of clinically meaningful mania at discharge⁵
• 90% of clients leave treatment with a positive attitude about taking their psychiatric medication³
• 85% of patients with psychosis experienced statistically significant improvement in their symptoms of psychosis⁶

Clients also complete diagnosis-specific assessments. These specialized evaluations measure improvement in function and reduction in symptoms for clients with specific diagnoses and provide a more detailed evaluation of treatment effectiveness in addition to the aggregate measures.

Patients admitting with bipolar mania were uniformly in remission from mania at discharge, meaning they no longer were experiencing symptoms of mania. Skyland Trail is looking at how to bring about remission for other diagnoses, specifically depression, and is moving the needle in that direction.

In 2020:

• 31% of patients with major depression were considered in remission—completely symptom-free—at discharge⁴
• 40% of patients with major depression improved by 50% or more⁴
• 88% of all patients with major depression experienced a clinical improvement in symptoms⁴

Key outcomes from 2020 demonstrate that patients who came to Skyland Trail for treatment during the pandemic were, in general, more complex and symptomatic than in previous years. Over 60 percent of all of the patients who were both admitted and discharged within the year 2020 had three or more validated psychiatric diagnoses. Further, a significant number of these complex patients experienced disabling anxiety that was associated with the pandemic. More patients with anxiety and depression also had co-morbid substance misuse of easily accessible substances such as alcohol and marijuana, likely due to delaying psychiatric care while isolating at home.

Outcomes research in 2020 explored the link between a history of trauma and response to treatment. Approximately 30 percent of adult patients in 2020 had histories of moderate or severe traumas, and individuals with sexual traumas showed statistically significant elevated levels of C-reactive Protein (CRP). CRP is an indicator of global body inflammation, and higher CRP levels suggest overall poorer physical health and treatment response compared to individuals with lower CRP levels. Based on this research, Skyland Trail is exploring opportunities to use CRP levels and trauma assessments to “predict” which patients will need specific trauma-informed therapies and connect patients with targeted interventions earlier in their treatment. 

References

1. t(259)=1302, p<.001 The 32-item Behavior and Symptom Identification Scale (BASIS-32): © Copyright McLean University, Affiliate of Harvard Medical School.
2. t(255)=9.04 p<.001 Beck Hopelessness Scale: Beck AT, Weissman A, Lester D, Trexler L. (1074). The measurement of pessimism: The Hopelessness Scale. Journal of Consulting and Clinical Psychology, 42(6), 861-865.
3. t(244)=-11.41, p=.001 Medication Attitude Inventory: Hogan TP, Awad AG, & Eastwood R. (1983). A self-report scale predictive of drug compliance in schizophrenics: reliability and discriminative validity. Psychological Medicine, 13, 177-183.
4. t(222) = 10.30, p =.000 Montgomery, S.A. & Åsberg, M. (1979). A new depression scale designed to be sensitive to change. British Journal of Psychiatry, 134, 382-389.
5. t(25)= 4.42, p=0.001 Young RC, Biggs JT, Ziegler VE, Meyer DA: A rating scale for mania: reliability, validity and sensitivity. British Journal of Psychiatry, 133:429-435, 1978.6 Hamilton M: The assessment of anxiety states by rating. British Journal of Medical Psychology, 32:50-55,1959.
6. t(46)= 11.8,  p=0.000 Overall JE, Gorham DR. The Brief Psychiatric Rating Scale. Psychological Reports. 1962; 10:799-812.

About Skyland Trail

Located in Atlanta, Skyland Trail is a nationally recognized nonprofit mental health treatment organization serving adults and adolescents with a primary psychiatric diagnosis. Through our residential and day treatment programs, we help our clients grow, recover, and reclaim their lives. We’re focused on individuals with complex mental health issues, helping them understand that they can be – and are – more than a diagnosis. We offer expert, evidence-based psychiatric care alongside a compassionate, holistic path to wellness. Our integrated mental, medical, and social model helps clients develop strategies to improve mental health, physical wellness, independence, and relationships with family and friends. Unique therapies offered include music, art and horticultural therapy; workforce and school readiness; primary care services; family therapy; and healthy living and nutrition coaching.

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