Dual diagnosis treatment programs are designed to help patients suffering from concomitant psychiatric illnesses or mental disabilities combined with substance abuse. These programs began to emerge in the mid-1980s in New York state when staff working in an outpatient mental health environment found themselves ill-equipped to deal with a large number of patients whose problems required a more more extensive range of treatment than they were able to provide.
Challenges Presented by Dual Diagnosis
Substance abuse and addiction can easily be confused with other psychiatric disorders, presenting those who are assessing a new patient with a number of questions. To distinguish between the two conditions, it can be necessary to first withdraw the substance gradually and then determine whether some of the patient’s problems resolve. One of the difficulties for those making a diagnosis is that, according to research, a up to half of those with underlying psychiatric conditions have at some time been affected by drug abuse. Similarly, more than half of substance abusers have been found to suffer from a concomitant mental disorder.
Integrated Treatment – Patients struggling with mental illnesses combined with addiction to substances often found themselves being bounced between different treatment centers, being exposed to poorly coordinated and poorly supervised treatment programs. Mental health services were unprepared to deal with those whose disorders were complicated by drug abuse, and drug rehabilitation centers were equally unprepared to help those with severe psychiatric disorders such as depression, psychosis or schizophrenia. Dual diagnosis programs emerged as a result of the integration of these specialties in an effort to provide this group of patients with comprehensive care under one roof.
Comprehensive Services and Long-term Support – Dual diagnosis treatment programs include services that extend far beyond the standard treatments for either drug rehabilitation or conventional psychiatric care. One example of the need for a wider spectrum of services can be found in the large number of patients who are homeless or who have been jailed. Among these marginal populations, a very significant percentage suffer from serious mental illnesses and concurrent abuse of addictive substances. One study found that among prison inmates with a mental disorder, more than 70 percent were also abusing drugs. This group was particularly vulnerable to being recycled through the healthcare and criminal justice systems without finding adequate support anywhere to enable them to escape the cycle.
Caregivers in dual diagnosis treatment programs are able to provide vulnerable populations with ongoing counseling, motivational interventions to help prevent relapse, intensive case management, and support in finding adequate housing and sources of income as the patient recovers. For dual diagnosis patients, recovery is a long-term process that involves participation in an effectively integrated treatment program, along with the support of social services and the community at large.