Three SAMHSA Overview Papers on Effective Approaches to Treating Co-occurring Disorders

Three brief overview papers from the Substance Abuse and Mental Health Services Administration (SAMHSA) provide information on how best to help people with co-occurring mental illness and substance use disorders. The reports are the last in a series of eight concise introductions that present information based on current research findings and best practices. The series, which was developed by SAMHSA's Co-occurring Center for Excellence (COCE), targets mental health and substance abuse treatment providers, administrators, and policy makers, although the reports also provide useful information to the general public.

Services Integration: Overview Paper 6 emphasizes that system- and program-level integration must lead to client-level integration of services: "Integrated programs are supported and facilitated by systems integration. However, unless integrated treatment is provided to clients, other forms of integration serve no purpose." After highlighting important research findings, the eight-page report uses a question-and-answer format to address issues such as the outcomes that can be expected for clients with co-occurring disorders who receive integrated treatment and the importance of workforce cross-training and support.

Systems Integration: Overview Paper 7 outlines the benefits of developing public health infrastructures that systematically integrate mental health and substance abuse treatment programs. The report emphasizes that creation of an integrated state mental health and substance abuse department is not synonymous with systems integration and that such a merger may actually create resistance within existing systems that impedes integration efforts. Seven organizational processes that have been shown to support systems integration are described, including creation of committed leadership teams and a continuous quality improvement model that empowers collaboration at all levels. The report warns that relying solely on blended or merged funding streams is both inefficient and likely to result in funding uncertainty and confusion. It encourages implementation strategies that support the integrity of existing funding streams while articulating the expectation that all funding streams, whether flexible or categorical, should carry instructions for appropriate integration at the client level.

The Epidemiology of Co-occurring Substance Use and Mental Disorders: Overview Paper 8 is presented in two parts. Part 1, for nonscientists, provides basic information about epidemiology and why the findings of epidemiological studies are important for policy makers and the general public. In particular, it focuses on three major studies that are regularly referenced as prime sources of information on the nature and scope of co-occurring disorders: the National Comorbidity Survey and the more recent National Comorbidity Survey-Replication, the National Survey on Drug Use and Health, and the National Epidemiologic Study on Alcohol and Related Conditions. Part 2 summarizes specific findings of these studies and points out similarities and differences in their findings.

The series of overview papers is available on the COCE Web site at www.coce.samhsa.gov.