Effective dual diagnosis programs combine mental health services and substance abuse interventions tailored specifically for the complex needs of those patients diagnosed as having dual diagnosis. Critical components of an effective dual diagnosis drug rehab program 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.
Since dual diagnosis became prevalent in the early 1980’s, researchers have found three basic and consistent findings. First, co-occurrence is fairly common since about 50% of individuals with severe mental disorders are affected by substance abuse and addiction treatment. Second, dual diagnosis is associated with a variety of negative outcomes such as higher rates of relapse, hospitalization, violence, incarceration, homelessness and serious medical problems such as HIV and hepatitis. Third, it is clear that our mental health system and substance abuse treatment system deliver fragmented and ineffective care for those individuals suffering from dual diagnosis. Since the 1980’s, a great deal of progress has been made in combining both care systems and effectively integrating these services to provide a more developed, refined and effective treatment method.
Drug rehab treatments or interventions combine mental health and substance abuse interventions at the level of the clinical interaction. This integrated treatment requires that the same professionals work in one setting and provide appropriate mental health and substance abuse treatment in a coordinated fashion. Integration involves combining appropriate treatments for both disorders while modifying traditional interventions. The goal of dual diagnosis intervention is recovery from not one, but two serious illnesses.
Critical components for dual diagnosis treatment include:
- Staged interventions. Forming a trusting relationship with the individual, helping the engaged client develop motivation to become recovery-oriented, helping the motivated individual acquire skills and supports for controlling their illness and pursuing goals and helping the client in stable remission develop and use strategies for maintaining their recovery.
- Assertive outreach. Effective treatment programs for dual diagnosis patients engage clients and members of their support systems by providing assertive outreach, usually through a combination of intensive case management and meetings in the client’s residence.
- Motivational interventions. Effective dual diagnosis programs incorporate motivational interventions that are designed to help clients become ready for more definitive interventions aimed at illness self-management. Motivational interventions help the individual identify his or her own goals and recognize that by not managing their illness, they are negatively impacting their goals.
- Counseling. By using group, individual and family counseling, effective dual diagnosis rehabilitation programs promote cognitive and behavioral skills.
- Social support interventions. These types of interventions focus on strengthening the social environment to help the individual modify their behavior and includes social networks and family interventions.
- Long-term perspective. Programs must take a long-term, community-based perspective for continuum of care to prevent relapse.
- Comprehensiveness. Combined mental health and substance abuse treatment must be all encompassing.
- Cultural sensitivity and competence. Programs must be tailored to suit the specific culture.
Although it is clear that both the mental health system and the substance abuse treatment system are very effective methods of treatment, the two methods must be uniformly combined into one effective program for those patients suffering from dual diagnosis. Both the substance abuse issue and the mental health issue must be addressed in treatment concurrently. Failure to treat both issues effectively would result in certain relapse.