Definition of Problem
Description of Preliminary Data Gathering, Collection, or Resource
The Research Design
Data Analysis and Interpretation
The Mental Health Essay and substance abuse fields have had a growing awareness
of the prevalence of co-occurring disorders and the challenges presented by
this population. The lack of success within traditional treatment settings
for individuals with co-occurring disorders is well documented. Estimates
suggest that while about 20 percent of the U.S. population is affected by
mental disorders in any given year, only one-third of people in need of
mental health treatment receive it.
When it comes to substance abuse
disorders, between 13 million and 16 million people need treatment for
alcoholism and/or drug abuse in any given year, but only 3 million (20
percent) receive care. 10 millions Americans met the criteria for co-
concurring disorders in any given year, but only half of the substance
abuse treatment facilities provided programs for dually diagnosed clients.
Out of all the State/local government operated facilities only 11 percent
provided services; (SAMHSA, 2003) and exclusions within these programs deny
services to individuals with certain diagnoses such as schizophrenia, and
Bi-polar disorders. There is a need to incorporate the treatment of dual
diagnosed clients to this program. The continuum of services would
increase by providing a comprehensive, integrating mental health and
addiction treatment into the program design.
Every individual regardless of the severity and disability associated with
his or her co-occurring disorders is entitled to experience the promise and
hope of recovery.
Admissions reports indicate that services are denied to a significant
number of clients that apply for services due to a mental illness. Clients
are being admitted and then mental health issues are revealed, resulting in
client being discharged from the program, or the problem is not being
addressed during the treatment stay. Presently if an individuals during
treatment is found to have a mental health issue and in need of
psychotropic medication they usually result in discharge from the program.
Even though the program attempts to exclude individuals with co-occurring
disorders, there are successful graduates with co-occurring disorders who
were not detected at the time of admission. In determining which
individuals are eligible for services the attempt to screen out individuals
with co-occurring mental disorders is done during the admission process.
Given the high frequency of co-occurring disorders in the United States,
this approach excludes a large number of potential admissions.
program design deprives those with the greatest needs from receiving
Data was gathered through literary surveys, observation, data bases,
websites, agency records, client survey data, and existing statistics from
state treatment agencies. Research was expedited by building on previous
research. Using the dependent variable access to services needed, and the
Independent variables: Substance abuse and mental disorders, dual diagnosed
clients: The intervening variable was integration of substance abuse and
mental health treatment services.
Despite increasing evidence that outcomes for persons with co-occurring
mental and substance use disorders improve when care is provided in a
comprehensive and integrated fashion. Providers in both systems still
tailor their approaches to treatment according to individual categories of
disorders with segregated admissions criteria, treatment programs, services
and reimbursement: (Drake et al.
, 2001) Resulting in consumers bouncing
back and forth between the mental health and substance abuse service
systems. “When substance abuse disorders and mental disorders occur at the
same time in an individual, they lead to significant loss of human
potential and increased costs for service systems – losses and costs
greater than those arising from each of the disorders alone. Moreover, a
growing body of evidence suggests that integrated rather than parallel and
sequential treatment approaches are especially effective for people with
more severe functional impairment due to co-occurring substance abuse
disorders and mental disorders.” (SAMHSA-2002) Historically mental health
and substance abuse treatment approaches have been somewhat different,
principles of care within the two fields converge on respect for the
individual, reaching out to engage those who cannot yet trust, and the
importance of community, family, and peers to the recovery process (Osher,
1996) The concept of “recovery” is now increasingly the focus of treatment
in both systems. Many researchers and clinicians believe that “both
disorders must be considered as primary and treated as such” (Ridgely,
Osher & Talbott, 1987; Minkoff, 1991; Drake, McLaughlin et al., 1991; Osher
and Kofoed, 1989).
There is a need to bridge the gap, and create an effective system of care
for persons with co-occurring disorders. Access to services remains elusive
to most individuals with this condition. Research indicates that mental
health and substance abuse providers alike encounter difficulties in
accessing comprehensive .