More than once, both as an auditor and more recently as a consultant, I have heard the comment when asking about treating or assessing substance use disorders – “oh, I don’t treat that”.
    It’s a reasonable response when you consider the specialization around treating substance use disorders. The challenge, then, is how do you go about working with individuals who have co-occurring mental health and substance use disorder diagnoses?
    In a 2018 article from the National Institute on Drug Abuse, part of the National Institutes of Health, it was identified that about 7.7 million people in the United States have a co-occurring mental health and substance use disorder, or around 37.9 % of SUD adults. Over half of those individuals receive no treatment at all, 34.5% receive only mental health treatment, 3.9% receive substance use disorder treatment only, and around 91.% receive integrated behavioral health and substance use disorder treatment.
    The Substance Use and Mental Health Services Administration (SAMHSA) makes a strong case for the positive impact of integrating care. Where it can be accomplished in one place is great, but it’s possible for small groups and individual practitioner to build cooperative treatment to be able to support clients through an integrative process.
    SAMHSA encourages a “No Wrong Door” system, that can support a client, whether they initiate treatment through substance use or mental health treatment first. It shows the real power of starting the treatment process through an effective assessment. Integrative treatment, both mental health and substance use treatment together or cooperatively, leads to better outcomes and quality of life.
    If you haven’t had much exposure with treating co-occurring disorders, SAMHSA, or how to work cooperatively with colleagues on the “other side” of the work, SAMHSA has a lot of material and videos worth watching. Their site includes a Treatment Improvement Protocol (that’s free) that is very much worth a read. You’ll find it at http://samhsa.gov/co-occurring-disorders.