This month's issue has a special focus on co-occurring disorders. The State Mental Health Policy column discusses lessons learned by seven states participating in COSIG (Co-occurring State Incentive Grant), a federally funded initiative to help state mental health and substance abuse authorities better integrate services for people with co-occurring disorders (page 903). Two articles report findings from analyses of Medicaid data from several states that attempted to better understand how beneficiaries with co-occurring disorders use services. Robin E. Clark, Ph.D., and colleagues found heavy inpatient and emergency department use and reduced use of community-based services in this population (page 942), and Mark P. McGovern, Ph.D., and colleagues found support in the data for the utility of the quadrant model, which groups persons with co-occurring disorders according to the disorder severity (page 949). Karen A. Urbanoski, M.Sc., and colleagues analyzed data from nearly 37,000 respondents to a Canadian survey. They found that persons with co-occurring disorders had high unmet need for care; they were the least satisfied with care and preferred self-management to the care they received (page 962). In Taking Issue Andrew E. Slaby, M.D., Ph.D., discusses the troubling nature of these findings and the sensitivity needed by practitioners to provide effective treatment to this population (page 897).