Developing standards of care for individuals with co-occurring psychiatric and substance use disorders.

  title={Developing standards of care for individuals with co-occurring psychiatric and substance use disorders.},
  author={Kenneth Minkoff},
  journal={Psychiatric services},
  volume={52 5},
  • K. Minkoff
  • Published 1 May 2001
  • Medicine
  • Psychiatric services
entire system of care and that require integrated system planning involving both mental health and substance abuse treatment agencies. Second, recent research on the implementation of clinical demonstration projects indicates that better outcomes are related to system-level changes that establish formal structures for interprogram collaboration at the administrative level that, in turn, support the work of the frontline clinicians at the program level. Thus the success of a particular… 
Perceptions of mental health and substance abuse program administrators and staff on service delivery to persons with co-occurring substance abuse and mental disorders
Efforts to coordinate service delivery across the two systems need to address divergent perceptions between staff in programs that are increasingly called upon to work together to jointly deliver services.
Competing institutional logics in the development and implementation of integrated treatment for concurrent disorders in Ontario: A case study
This study explored how two different institutional logics – managerial strategies striving for treatment effectiveness and client-centered care – guide the implementation of integrated treatment for concurrent disorders in Ontario, Canada.
Integrating Care for People With Co-Occurring Alcohol and Other Drug, Medical, and Mental Health Conditions
Although few studies have been done in this field, findings suggest that patients receiving integrated treatment may have improved outcomes, and barriers to the implementation of integrative models, such as one proposed by the Institute of Medicine, remain.
Treatment for Dual Diagnosis Patients in the Psychiatric and Substance Abuse Systems
To improve the provision of high-quality dual-focused care, planners' use of cross-system teams and applications of recently produced tools designed to increase programs' ability to deliver integrated care to dually disordered individuals are recommended.
Health service systems and comorbidity: stepping up to the mark
This paper outlines key models and provides examples, while considering their potential for appropriately addressing the needs of this client group, and considers the benefits of an interaction between stepped care and the chosen model.
Service integration for the dually diagnosed.
Four case studies are offered as a means of illustrating the ways in which projects undertaken in local community health services have approached dual diagnosis treatment for clients, reflecting how cooperation and cross-referral between services, as well as effective management of dual diagnosis clients by suitably qualified staff can produce benefits to clients who use the service.
Finding the Balance in Evolving Service Sectors for Youth with Co-Occurring Disorders: Measurement and Policy Implications
Findings suggest attention to early assessment and appropriate intervention for the treatment of co-occurring disorders may play a critical role in treating rural youth and their families in their communities, limiting the over-reliance of residential care and other out-of-home placements.
Services to Patients with Dual Diagnoses: Findings from Washington's Mental Health Service System
Examination of Washington State's mental health treatment system indicated that best practices are not consistently implemented and administrative and provider barriers hinder provision of more effective care.
Meeting the Treatment Needs of Multiply Diagnosed Consumers
This article outlines the discussion and findings of this panel on the numerous treatment needs of consumers with multiple diagnoses and the converging and conflicting treatment models that have been developed for them.


Implementing dual diagnosis services for clients with severe mental illness.
The authors describe the critical components of effective programs, which include a comprehensive, long-term, staged approach to recovery; assertive outreach; motivational interventions; provision of help to clients in acquiring skills and supports to manage both illnesses and to pursue functional goals; and cultural sensitivity and competence.
Review of integrated mental health and substance abuse treatment for patients with dual disorders.
Ten recent studies of comprehensive, integrated outpatient treatment programs provide encouraging evidence of the programs' potential to engage dually diagnosed patients in services and to help them reduce substance abuse and attain remission.
Treatment of Substance Abuse in Severely Mentally Ill Patients
Current clinical research converges on several emerging principles of treatment that address the scope, pace, intensity, and structure of dual-diagnosis programs.
The epidemiology of co-occurring addictive and mental disorders: implications for prevention and service utilization.
General population data from the National Comorbidity Survey are presented on co-occurring DSM-III-R addictive and mental disorders, with the finding that fewer than half of cases with 12-monthCo-occurrence received any treatment in the year prior to interview suggests the need for greater outreach efforts.
Comorbidity of mental disorders with alcohol and other drug abuse. Results from the Epidemiologic Catchment Area (ECA) Study.
Comorbidity of addictive and severe mental disorders was highest in the prison population, most notably with antisocial personality, schizophrenia, and bipolar disorders.
Program components of a comprehensive integrated care system for serious mentally ill patients with substance disorders.
  • K. Minkoff
  • Medicine, Psychology
    New directions for mental health services
  • 1991
Using an integrated theoretical framework, a continuous and comprehensive model system of care for dual diagnosis patients can be designed.
plementing dual diagnosis services for clients with severe mental illness
  • Psychi - atric Services
  • 2001
Treatment of substance use disorders in severely mentally ill patients
  • Journal of Nervous and Mental Disease
  • 1993