Evidence-Based Practices: Shaping Mental Health Services Toward Recovery

Implementation Resource Kit User's Guide

Foreword

The Substance Abuse and Mental Health Services Administration's (SAMHSA) Center for Mental Health Services (CMHS) is a proud sponsor of this implementation resource kit for integrated treatment of dual disorders. As the federal agency responsible for promoting the quality, availability, and accessibility of services for people with mental illness, CMHS is responsible for identifying treatments for mental illness that work. The materials in this resource kit document the evidence for the effectiveness of integrated treatment of dual disorders and provide detailed information to help communities to implement the practice in real world settings. During development of the implementation resource kit, we placed special emphasis on 1) strengthening the consensus-building process, 2) expanding the involvement of consumers and families, 3) including practical orientation to issues involving service organization and financing, and 4) insisting on paying careful attention to issues of ethnic and cultural sensitivity and overall cultural competence. We are well pleased with the result.

Many other organizations contributed to developing this implementation resource kit. This broad coalition of researchers, providers, administrators, policy makers, consumers and family members, gives the resource kit its strength and vitality. We are especially appreciative of the support provided by The Robert Wood Johnson Foundation that sponsored the early stages of the Project, when evidence-based integrated treatment of dual disorders was identified as a practice ready for widespread implementation. We agreed. Substance abuse is the most common and clinically significant comorbid disorder among adults with serious mental illnesses. Research and clinical experience have yielded four basic and consistent findings regarding co-occurring psychiatric and substance use disorders: 1) about 50 percent of people with serious mental disorders are affected by substance abuse; 2) dual disorders are associated with increased rates of relapse, violence, incarceration, homelessness, and serious infections such as HIV and hepatitis; 3) most mental health providers are not trained to deliver substance abuse treatment interventions; and 4) the parallel, but separate, mental health and substance abuse treatment systems that are common in the United States deliver fragmented and ineffective care for individuals with dual disorders.

This implementation resource kit reflects the current state-of-the-art concerning evidence-based integrated dual disorders services. It addresses both the "key ingredients" of the clinical model and many practical considerations essential for successful implementation. It also describes the need for each community to adapt the model to its particular needs and characteristics. Careful attention to unique community needs, coupled with fidelity to the key ingredients of the practice, equals successful implementation. The closer the kit user comes to following the implementation resource kit guidance, the more likely the practice will yield good results for consumers.

As mental health services research and evaluation progress, CMHS hopes to support the development of implementation resource kits for additional evidence-based practices, and to refine this and other previously-developed resource kits to take new evidence into account. Indeed, evaluation of planned pilot projects for implementing this resource kit and associated implementation strategies will tell us much about how to make improvements in future versions. We hope that this and other evidence-based practice implementation resource kits will be helpful to communities across the nation as they strive to provide the most effective services possible for persons suffering from mental illness.

TOC | Previous | Next