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Evolving U.S. service model for patients with severe mental illness and co-occurring substance use disorder

Published online by Cambridge University Press:  24 June 2014

R. E. Drake*
Affiliation:
New Hampshire-Dartmouth Psychiatric Research Center Dartmouth Medical School, New Hampshire, USA
G. Morse
Affiliation:
Community Alternatives, and University of Missouri at St. Louis, St. Louis, Missouri, USA
M. F. Brunette
Affiliation:
New Hampshire-Dartmouth Psychiatric Research Center Dartmouth Medical School, New Hampshire, USA
W. C. Torrey
Affiliation:
New Hampshire-Dartmouth Psychiatric Research Center Dartmouth Medical School, New Hampshire, USA West Central Services, Lebanon, New Hampshire, USA
*
Robert E. Drake, Research Center, 2 Whipple Place, Lebanon, NH 03766. Tel: 603–448–0126; E-mail: [email protected]

Abstract

Co-occurring severe mental illness and substance use disorder has been recognized as a common problem in the U.S. since the early 1980s (1–3). For these individuals with co-occurring disorders, research demonstrates the effectiveness of various forms of combining, blending, or integrating mental health and substance abuse treatments (4). The evolving U.S. service model for integrated dual disorders treatment emphasizes several key elements: implementation, leadership, training, engagement, assessment, counseling for all patients, ancillary treatments for those with multiple needs, secondary treatments for patients who are nonresponders, and quality assurance regarding process and outcomes.

Type
Research Article
Copyright
Copyright © 2004 Blackwell Munksgaard

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References

Bachrach, LL. Young adult chronic patients: An analytical review of the literature. Hosp Community Psychiatry 1982;33: 189197.Google ScholarPubMed
Caton, C. The new chronic patient and the system of community care. Hosp Community Psychiatry 1981; 32: 475478.Google ScholarPubMed
Pepper, B, Krishner, MC, Ryglewicz, H. The young adult chronic patient: Overview of a population. Hosp Community Psychiatry 1981;32: 463469.Google Scholar
Drake, RE, Mercer-McFadden, C, Mueser, KT, McHugo, GJ, Bond, GR. Review of integrated mental health and substance abuse treatment for patients with dual disorders. Schizophr Bull 1998;24: 589608.CrossRefGoogle ScholarPubMed
Drake, RE, Essock, SM, Shaner, A, Carey, KB, Minkoff, K, Kola, L, Lynde, D, Osher, FC, Clark, RE, Richards, L. Implementing dual diagnosis services for clients with severe mental illness. Psychiatr Serv 2001;52: 469476.CrossRefGoogle ScholarPubMed
Regier, DA, Farmer, ME, Rae, DS, Locke, BZ, Keith, SJ, Judd, LL, Goodwin, FK. Comorbidity of mental disorders with alcohol and other drug abuse. JAMA 1990;264: 25112518.CrossRefGoogle ScholarPubMed
Ridgely, MS, Osher, FC, Goldman, HH, Talbott, JA, eds. Chronic mentally ill young adults with substance abuse problems. a review of research, treatment, and training issues. Task Force on Chronic Mentally Ill Young Adults with Substance Problems. Baltimore: University of Maryland School of Medicine, Mental Health Services Research Center, 1987. Google Scholar
Ries, R, ed. Assessment and Treatment of Patients with Coexisting Mental Illness and Alcohol and Other Drug Abuse. Treatment Improvement Protocol (TIP) Series. Rockville, MD: Substance Abuse and Mental Health Services Administration, 1994. Google Scholar
Onken, LSBlaine, JDGenser, SHorton, AM, eds. Treatment of Drug-Dependent Individuals with Comorbid Mental Disorders. NIDA Research Monograph 172. Bethesda MD: National Institute of Drug Abuse, 1997. Google Scholar
Mueser, KBellack, ABlanchard, J. Comorbidity of schizophrenia and substance abuse. J Consult Clin Psychol 1992;60: 845856.CrossRefGoogle ScholarPubMed
Minkoff, K. An integrated treatment model for dual diagnosis of psychosis and addiction. Hosp Community Psychiatry 1989;40: 10311036.Google ScholarPubMed
Fox, L. Surviving and thriving with a dual diagnosis. Understanding Stress Anxiety and Depression 1998;2: 57. Google Scholar
Caswell, JS. Employment: A consumer's perspective. In: Becker, DRBarcus, M, eds. Connections – State Partnership Initiative. Fairfax, VA: Virginia Commonwealth University, 2001: 5. Google Scholar
Green, VL. The resurrection and the life. Am J Orthopsychiatry 1996;66: 1216.CrossRefGoogle ScholarPubMed
Anthony, WA. Recovery from mental illness: The guiding vision of the mental health service system in the 1990s. Psychosocial Rehab J 1993;16: 1123. CrossRefGoogle Scholar
Deegan, PE. Recovery: The lived experience of rehabilitation. Psychosocial Rehab J 1988;11: 1119. CrossRefGoogle Scholar
Mead, SCopeland, ME. What recovery means to us. Consumers' perspectives. Community Ment Health J 2000;36: 315328.CrossRefGoogle ScholarPubMed
Rapp, CA. The Strengths Model. New York, NY. Oxford University Press, Inc. 1998. Google Scholar
Drake, REMueser, KTClark, REWallach, MA. The course, treatment, and outcome of substance disorder in persons with severe mental illness. Am J Orthopsychiatry 1996;66: 4251.CrossRefGoogle ScholarPubMed
Carey, K B. Substance use reduction in the context of out-patient psychiatric treatment: a collaborative, motivational, harm reduction approach. Community Ment Health J 1996;32: 291306.CrossRefGoogle Scholar
Osher, FCKofoed, LL. Treatment of patients with psychiatric and psychoactive substance use disorders. Hosp Community Psychiatry 1989;40: 10251030.Google Scholar
McHugo, GJDrake, REBurton, HLAckerson, TH. A scale for assessing the stage of substance abuse treatment in persons with severe mental illness. J Nerv Ment Dis 1995;183: 762767.CrossRefGoogle ScholarPubMed
Turner, JCTenhoor, WJ. The NIMH community support program: Pilot approach to a needed social reform. Schizophr Bull 1978;4: 319348. CrossRefGoogle Scholar
Minkoff, K. An integrated model for the management of co-occurring psychiatric and substance disorders in managed care systems. Dis Mgt Health Outcomes 2000;8: 251257. CrossRefGoogle Scholar
Institute of Medicine. Broadening the Base of Treatment for Alcohol Problems. Washington, DC: National Academy Press, 1990. Google ScholarPubMed
Torrey, WC, Drake, RE, Cohen, M, Fox, LB, Lynde, D, Gorman, P, Wyzik, P. The challenge of implementing and sustaining integrated dual disorders. Community Ment Health J 2002;38: 507521.CrossRefGoogle ScholarPubMed
Brunette, MF, Drake, RE. Clinician Workbook for Integrated Dual Disorders Treatment. Rockville, MD: Substance Abuse and Mental Health Services Administration U.S. Public Health Service, 2002. Google Scholar
Mercer-McFadden, C, Drake, RE, Brown, NB, Fox, RS. The community support program demonstrations of services for young adults with severe mental illness and substance use disorders 1987–91. Psychiatr Rehab J 1997;20: 1324. CrossRefGoogle Scholar
Bellack, AS, Diclemente, CC. Treating substance abuse among patients with schizophrenia. Psychiatr Serv 1999;50: 7580.CrossRefGoogle ScholarPubMed
Mueser, KT, Drake, RE, Noordsy, DL. Integrated mental health and substance abuse treatment for severe psychiatric disorders. J Pract Psychiatry Behav Health 1998;4: 129139. Google Scholar
Alverson, H, Alverson, M, Drake, RE. An ethnographic study of the longitudinal course of substance abuse among people with severe mental illness. Community Ment Health J 2000;36: 557569.CrossRefGoogle ScholarPubMed
Mueser, KT, Fox, L. A family intervention program for dual disorders. Community Ment Health J 2002;38: 253270.CrossRefGoogle ScholarPubMed
O'Keefe, C, Potenza, DP, Mueser, KT. Treatment outcomes for severely mentally ill patients on conditional discharge to community-based treatment. J Nerv Ment Dis 1997;185: 409411.CrossRefGoogle ScholarPubMed
Brunette, MF, Drake, RE, Woods, M, Hartnett, T. A comparison of long-term and short-term residential treatment programs for dual diagnosis patients. Psychiatr Serv 2001;52: 526528.CrossRefGoogle ScholarPubMed
Shaner, A, Tucker, DE, Roberts, LJ, Eckman, TA. Disability income, cocaine use and contingency management among cocaine dependent schizophrenic patients. In: Higgins, ST, Silverman, K, eds. Motivating Behavior Change Among Illicit-Drug Abusers: Contemporary Research on Contingency Management Interventions. Washington, DC: American Psychological Association, 1999: 95122. CrossRefGoogle Scholar
Green, AI, Zimmet, SV, Strous, RD, Schildkraut, JJ. Clozapine for comorbid substance use disorder and schizophrenia: Do patients with schizophrenia have a reward–deficiency syndrome that can be ameliorated by clozapine? Harvard Rev Psychiatry 1999;6: 287296. CrossRefGoogle ScholarPubMed
Mueser, KT, Rosenberg, SD. Treatment of posttraumatic stress disorder in persons with severe mental illness. In: Wilson, JP, Friedman, M, Lindy, L, eds. Core Approaches for the Treatment of PTSD. New York, NY: Guilford Press, 2001: 354382. Google Scholar
Mueser, KT, Noordsy, DL, Fox, L, Wolfe, R. Disulfiram treatment for alcoholism in severe mental illness. Am J Addictions 2003;12: 242252. CrossRefGoogle ScholarPubMed
Jerrell, JM, Ridgely, MS. Impact of robustness of program implementation on outcomes of clients in dual diagnosis programs. Psychiatr Serv 1999;50: 109112.CrossRefGoogle ScholarPubMed