Best Practices - Concurrent Mental Health and Substance Use Disorders

2002
ISBN: 0-662-31388-7
Cat. No.: H39-599/2001-2E

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Table of Contents

• Acknowledgments
• Project Team Membership
• Expert Panel Membership
• Executive Summary
• Introduction
  • Project Scope
• Background, Definitions and Approach
  • Background to the Report
    • Concurrent Disorders are a Recognized Priority
    • The Rapidly Growing Literature
    • Intended Audience
  • Defining Concurrent Disorders
    • The DSM Classification System
    • Alternative Technology
    • Interaction Models
    • Stage of Treatment/Motivation
    • Classifying on the Basis of Severity
    • Approach Base on DSM
    • Current Limitations of the Data Regarding Substance Use
  • Defining Integrated Treatment
    • Integrated vs Sequential vs Parallel Treatment
    • The Need for New Systems Terminology
    • The Need to Monitor Integrated Activities
    • The Need for Psychosocial Supports
  • Rationale for Best Practice Guidelines
    • Prevalence Rates
    • Relationship to Treatment Outcome and Other Clinical Issues
    • Service Integration, Coordination and Planning
    • Summary
  • The Approach to Defining Best Practice for this Project
    • Evidence-Based Versus Expert Consensus
    • Approach
• Best Practice for Concurrent Disorders at the Service Delivery Level
  • Best Practice in Screening for Substance Use and Mental Health Disorders
    • General Issues in Screening
    • Screening for Substance Use Disorders
    • Screening for Mental Health Disorders
  • Best Practice in the Assessment of People with Concurrent Disorders
    • General Issues in Assessment
    • Alternative Approached and Measures
    • Assessing Stage of Change and Treatment Motivation
    • Assessing Psychosocial Functioning
  • Best Practice for the Treatment/Support of People with Concurrent Disorders
    • Co-occuring Substance Abuse and Mood and Anxiety Disorders
    • Co-occuring Substance Abuse and Severe and Persistent Disorders
    • Co-occuring Substance Abuse and Personality Disorders
    • Co-occuring Substance Abuse and Eating Disorders
• Implicatlion of Best Practice Guidelines at the System Level
  • Historical Perspective and Current Status
    • Similarities Across the Two Systems
    • A Less Prescriptive Approach at the System Level
  • The Consumer's Experience and Perspective
    • Results on Focus Groups
    • System Implications
  • Service Provider and Planner Perspectives
  • Mechanisms and Models for System-level Integration for Concurrent Disorders
    • What the Literature Tells Us About the Effectiveness of Coordination
    • Barriers to Integration and Potential Solutions
    • A Shopping List of Alternatives to Support System Integration
• Implications for Research
• Appendices
  • Appendix A - Key Reference Materials
  • Appendix B - DSM-IV Criteria for Substance Use Disorders and Substance-Induced Disorders
  • Appendix C - Classification Scheme from Ryglewicz and Pepper
  • Appendix D - Brief Description of the Mental Health and Substance Abuse Treatment Systems in Canada
  • Appendix E - Terms for Substance Abuse and Mental Healht Screening
  • Appendix F - Checklist of Common Consequences of Sustance Abuse
  • Appendix G - Tools and Interventions for Working with People with Co-occuring Substance Abuse and Severe and Persistent Mental Illness
  • Appendix H - Topic List for Focus groups
  • Appendix I - Program Integration Fidelity Scale
• References