Evidence-Based Practices: Shaping Mental Health Services Toward Recovery

Co-Occurring Disorders:
Integrated Dual Disorders Treatment

Information for Consumers

Dual disorders refers to the presence of both a severe mental illness and a substance use disorder. Integrated dual disorders treatment has been shown to work effectively for consumers with both disorders. In this treatment model, one clinician or treatment team provides both mental health and substance abuse treatment services.

Recovery from mental illness and substance use

As people with mental illnesses, we are also prone to develop problems with alcohol and drug use. We tend to use drugs and alcohol for the same reasons that people without a mental illness do, but we are often more sensitive to the negative effects of alcohol and drugs.

The result is that one of every two individuals with severe mental illness has the additional problem of substance use disorder, (which means abuse or dependence related to alcohol or other drugs).

There is good news.

Most of us with dual disorders can achieve recovery. And our lives are much better when we are in recovery. Building a satisfying and meaningful life without drugs or alcohol requires time, support, education, courage, and learning new skills.

How can people with dual disorders achieve recovery from both mental illness and substance abuse?

Most people with dual disorders are able to achieve recovery. The chance of recovery improves when people receive integrated dual disorders treatment, which means combined mental health and substance abuse treatment from the same clinician or treatment team.
Relapses do happen, but most people are able to recover from relapses relatively quickly and get back to where they were before they relapsed.
Families and clinicians cannot force people to give up alcohol and drugs. Family and other supporters can help by providing support and hope, but recovery must be a person's own choice. It may take a long time for some people to achieve recovery.
People with dual disorders can learn from peers who are in recovery. Some may benefit from self-help groups like Alcoholics Anonymous, Narcotics Anonymous, and Dual Recovery Anonymous. It is a matter of personal preference.

What is integrated dual disorders treatment?

Integrated Dual Disorders Treatment occurs when a person receives combined treatment for mental illness and substance use from the same clinician or treatment team.

It helps people develop hope, knowledge, skills, and the support they need to manage their problems and to pursue meaningful life goals.

You will know if you are receiving integrated treatment because your clinician or treatment team will do several things at the same time, including:

Help you think about the role that alcohol and other drugs play in your life. This should be done confidentially, without any negative consequences. People feel free to discuss these issues when the discussion is confidential, nonjudgmental, and not tied to legal consequences.
Offer you a chance to learn more about alcohol and drugs, to learn about how they interact with mental illnesses and with medications, and to discuss your own use of alcohol and drugs.
Help you become involved with supported employment and other services that may help your process of recovery.
Help you identify and develop your own recovery goals. If you decide that your use of alcohol or drugs may be a problem, a counselor trained in integrated dual disorders treatment can help you identify and develop your own recovery goals. This process includes learning about steps toward recovery from both illnesses.
Provide special counseling specifically designed for people with dual disorders. If you decide that your use of alcohol or drugs may be a problem, a trained counselor can provide special counseling specifically designed for people with dual disorders. This can be done individually, with a group of peers, with your family, or with a combination of these.

If you are a person with dual disorders, participating in integrated dual disorders treatment is extremely important.

Effective treatment will help reduce the risk for many additional problems, such as increased symptoms of a mental illness, hospitalizations, financial problems, family problems, homelessness, suicide, violence, sexual and physical victimization, incarceration, serious medical illnesses, such as HIV and hepatitis B and C, and sometimes even early death.

What can you, as a consumer with dual disorders, do?

Get more information and support about what having dual disorders means and how it affects your recovery process.
Do everything you can to build a positive life for yourself without alcohol and drugs. For most people recovery includes meaningful activities, like a job, friendships with people who do not use alcohol or drugs, a safe place to live, and enjoying leisure activities that are fun and relaxing. This all takes time. Don't give up.
If you are having trouble with your mental illness as well as with substance abuse, it is important to talk with mental health professionals about how to get your symptoms under better control, and how to improve your recovery process.

For more information

Information about integrated dual disorders treatment, as well as other evidence-based practices for the treatment of mental illness in the community, can be found at www.mentalhealthpractices.org.

This document is part of an evidence-based practice implementation resource kit developed through a contract (no. 280-00-8049) from the Substance Abuse and Mental Health Services Administration's (SAMHSA) Center for Mental Health Services (CMHS) and a grant from The Robert Wood Johnson Foundation (RWJF), and support from the West Family Foundation. These materials are in draft form for use in a pilot study. No one may reproduce, reprint, or distribute this publication for a fee without specific authorization from SAMHSA.

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