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SAMHSA News - November/December 2007, Volume 15, Number 6

Co-Occurring Disorders: Systems Integration, Epidemiology

By Erin Bryant

Improving services for individuals with co-occurring mental health and substance use disorders is one of SAMHSA's priorities.

As part of the Agency's continuing series on this subject, SAMHSA's Co-Occurring Center for Excellence (COCE) recently released two new publications based on current science, research, and practices.

The COCE series is intended to inform mental health and substance abuse administrators and policymakers about the most current research and treatment practices.

Overview Paper 7

An integrated approach to services—systems integration—improves treatment outcomes for individuals with co-occurring disorders.

Overview Paper 7 defines systems integration as the process through which health and behavioral systems (i.e., agencies, organizations, and individuals) organize themselves to combine services for patients with co-occurring disorders.

The paper explains how this integrated approach can help clinicians treat clients with co-occurring disorders. It also explains the types of organizational structures that support systems integration and addresses funding challenges.

Systems integration is a developing field; however, the paper presents real-world examples of integration and the organizational processes that support it.

The type and means of integration will vary for different service components and levels of care. Integration can refer to the combination of services (such as screening and assessment), or it can refer to the combination of service levels (such as individual practitioners and states).

Still, the goal of systems integration remains the same: To identify and manage co-occurring disorders and the interactions between them.

Overview Paper 8

High-quality epidemiologic data are important for planning services and building service systems for affected populations.

Epidemiology is the study of the number of people who have a condition, the rate that new cases are occurring, and the distribution of the illness in the population.

For example, an epidemiologist may study the number of people with co-occurring disorders, where they live, and if they are receiving treatment.

Overview Paper 8 defines the study of epidemiology and how it can be useful to practitioners, administrators, and policymakers.

Part 1 of the paper introduces three major national studies and presents highlights from past epidemiological studies of co-occurring disorders. Part 2 delves into these studies in more detail, including methods and findings.

Knowing that rates of co-occurring disorders are higher for certain people can help providers with screening. Administrators can use these data to identify areas where specialized services and targeted outreach may be appropriate. Policymakers can identify treatment and prevention needs and determine appropriate resource allocation.

To read about other publications in this series, see SAMHSA News online, September/October 2007 and July/August 2007.

To Order

For free print copies, call 1-877-SAMHSA-7 (1-877-726-4727). For Overview Paper 7, request inventory number SMA07-4295. For Overview Paper 8, request number SMA07-4308.

On the SAMHSA Web site, all the COCE papers are available for free download at

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