The Case for Screening and Treatment of Co-Occurring Disorders
The presence of two or more disorders can complicate diagnosis and treatment. Integrating both screening and treatment for mental and substance use disorders leads to a better quality of care and health outcomes for those living with co-occurring disorders by treating the whole person.
SAMHSA offers evidence-based resources to help providers screen, diagnose, and deliver integrated care to patients with co-occurring disorders.
People with co-occurring disorders are more likely to be hospitalized than people with a mental or substance use disorder alone. Integrated treatment coordinates mental and substance use interventions by linking people to other providers who can deliver individualized and personalized services to treat the physical and emotional aspects of mental and substance use disorders. There are three models for delivering care for co-occurring disorders: coordinated, co-located, and fully integrated. With integrated care, a more complete recovery is possible.
Together with early detection, integrated treatment can improve outcomes and quality of life for people with co-occurring disorders, including:
- Reduced or discontinued substance use
- Improvement in psychiatric symptoms and functioning
- Increased chance for successful treatment and recovery for both disorders
- Improved quality of life
- Decreased hospitalization
- Reduced medication interactions
- Increased housing stability
- Fewer arrests
Effective Systems Ensure “No Wrong Door” to Enter Treatment
SAMHSA’s “no wrong door” policy states that effective systems must ensure that a person needing treatment will be identified, assessed, and receive treatment, either directly or through appropriate referral, no matter where he or she seeks services.
“No wrong door” means that people presenting for treatment for a mental disorder should be routinely screened for substance use disorder, and all people presenting for treatment for substance use disorders should be screened for mental disorders.
The SAMHSA Treatment Improvement Protocol (TIP)
The Substance Use Disorder Treatment for Persons with Co-Occurring Disorders: A Treatment Improvement Protocol (TIP Series, No. 42) from SAMHSA offers newly updated, best practice guidelines for preventing and treating substance use and mental disorders.
These guidelines assist clinicians in the screening, assessing, diagnosing, and managing co-occurring disorders, enabling them (whether within the substance abuse or mental health treatment system) to apply coherent, stepwise approaches in developing and using treatment protocols.
If you, or someone you know, needs help with co-occurring mental and substance use disorders, call SAMHSA’s National Helpline at 1-800-662-HELP (4357) or TTY: 1-800-487-4889, or text your zip code to 435748 (HELP4U) for 24-hour, free, and confidential information and treatment referral or use SAMHSA’s Behavioral Health Treatment Services Locator to find help.
References and Relevant Resources
- Find Treatment
- Integrated Treatment for Co-Occurring Disorders Evidence-Based Practices (EBP) KIT l SAMHSA
- 2019 National Survey on Drug Use and Health | SAMHSA
- An Introduction to Bipolar Disorders and Co-Occurring Substance Use Disorders l SAMHSA
- People Recover l SAMHSA
- Technology Transfer Centers (TTC) Program l SAMHSA
- Co-Occurring Substance Use and Mental Disorders Among Adults with Opioid Use Disorder l Drug and Alcohol Dependence