Document Type

Final Project

Graduation Date

Spring 5-6-2023

Degree Name

Doctor of Nursing Practice

First Advisor

Nicholas Guenzel

Second Advisor

Leeza Struwe


Background: Social distancing measures associated with the COVID-19 pandemic began on March 28th, 2020in the United States. With these implemented measures, the mental health of the population was worsening due to isolation, closures, and fear. Rates of anxiety, depression, and co-occurring substance abuse increased as well. CenterPointe is a behavioral health organization that has a residential treatment facility in Omaha, Nebraska for patients with mental health and substance use disorder dual diagnoses. They utilize the DLA-20 tool with their patients at intake, every 90 days, and at discharge. The DLA-20 is a standardized tool that assesses an individual’s functioning in daily life.

Objectives: The purpose of this study was to identify the effect of COVID on daily functioning by analyzing the DLA-20 scores, identify treatment completion and goals met, determine prominent demographic data, and to analyze changes in mental health or substance use disorder diagnoses.

Method: This was a retrospective cohort study analyzing a deidentified data set with two groups. The groups were pre-COVID (March 29th, 2018- March 29th, 2020) and post-COVID (March 30th, 2020-March 23th, 2022) and consisted of individuals in CenterPointe’s residential treatment program.

Results: Individuals admitted during COVID had higher DLA scores on admission than individuals admitted pre-COVID. Fewer individuals had completed treatment as well as met their goals with COVID compared to pre-COVID. The results also revealed a decrease in the homeless population and an increase in unemployed individuals post-COVID. Nicotine use decreased by 5% and cocaine use increased by 4% post-COVID.

Conclusions: The DLA-20 results revealed that people in the post-COVID category entered the treatment program with a higher DLA score indicating a higher level of functioning than individuals admitted during the height of the pandemic. This indicates that the COVID-19 pandemic may not have caused an increase in symptoms and impairment of functioning among the individuals being treated at CenterPointe’s residential treatment center as originally assumed. The study also highlighted the usefulness of the DLA-20 tool to assess functioning in individuals with a mental health and substance use disorder diagnosis amidst the COVID-19 pandemic.

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