Transporting to Treatment: Evaluating the Effectiveness of a Mobile Engagement Unit

Abstract Background Substance use treatment providers have increasingly developed novel engagement and low-threshold treatment services (such as mobile treatment units) to meet the needs of people with opioid use disorder (OUD). Use of these service models has outpaced the research on their effectiveness. The current study examines the effectiveness of a mobile engagement unit in connecting individuals with OUD to a treatment program. Methods This retrospective cohort study included 468 Medicaid-enrolled individuals served through a managed care behavioral health system. Analyses used administrative data from 2018-2019 to compare the characteristics and service use of individuals transported to an intake appointment by a mobile engagement unit with individuals who arrived through typical referral routes such as walk-in, other providers, and court order. The authors employed a difference-in-differences analysis to adjust for prior service history. The outcomes of interest were any utilization of substance use treatment services. Results The groups were virtually identical in age and gender, prior to matching, except for race where there was a lower proportion of Black individuals (17% versus 44%) and lower pre-service utilization of outpatient and methadone services by the mobile group. Following intake, mobile participants used significantly more outpatient substance use treatment services (23 percentage point relative increase) and methadone maintenance (32 percentage point relative increase) than the comparison group. Conclusions The results of this study suggest that mobile engagement units designed to identify and serve individuals with OUD in the community hold promise for reaching underserved high-risk populations and reduce barriers to treatment entry and recovery.