# Presentation: 913521

## Breaking New Ground: Integrated Treatment for Co-Occurring Disorders

- October 31, 2005 | Eau Claire, WI

**A. KATHRYN POWER, DIRECTOR**
**Center for Mental Health Services**
**Substance Abuse and Mental Health Services Administration**

## Co-Occurrence of Serious Psychological Distress and  Substance Use Disorders Among Adults Aged 18 or Older: 2004

**15.2 Million**

**16.8**
**Million**

**Co-Occurring**
**Disorders**

**Substance abuse disorder **
**only**

**Serious**
**psychological**
**distress **
**only**

**4.6 Million**

## Past-Year Treatment Among Adults Aged 18 or Older with Co-Occurring Serious Psychological Distress and a Substance Abuse Disorder: 2004

**Past-Year Treatment Among Adults Aged 18 or ****Older with Co-Occurring Serious Psychological Distress and a Substance Abuse Disorder: 2004**

**Treatment only for substance abuse**

**4.6 Million Adults with Co-Occurring Mental and Substance Abuse Disorders**

**Treatment for both mental health and substance abuse disorders**

**No treatment**

**41.4%**

**47.5%**

**6.0%**

**5.0%**

**Treatment only for mental health disorders**

## Integrated Treatment―

- refers to *any* mechanism by which treatment interventions for both disorders are combined within the context of a primary treatment relationship or service setting.

## We will help [the survivors] regain their dignity in the face of their losses. [We will] give families some measure of privacy and access to public transportation and to the culture and services that our cities provide. Those who have lived through this ordeal deserve the chance to quickly return their lives to normal.  

- ―Governor Jim Doyle

- AP photo by Rod Hubar,
*Orlando Sentinel*

## SAMHSA’s Ongoing Response to Hurricanes Katrina and Rita

- Suicide crisis hotline
- SAMHSA’s Emergency Response Center (SERC)
- Disaster Technical Assistance Center
- Emergency response grants
- Onsite support by deployed SAMHSA staff specialists
- Onsite assistance by SAMHSA’s technical assistance centers on consumer/peer-run programs

## SAMHSA’s Four “Redwoods”

- Address the needs of adults and youth with co-occurring mental and substance abuse disorders.
- Build substance abuse treatment capacity.
- Implement the Strategic Prevention Framework.
- Transform the mental health system.

## U.S. Department of Health and Human Services

**U.S. Department of Health and Human Services**

**Substance Abuse and Mental**
**Health Services Administration**
**(SAMHSA)**

**Center for**
**Mental **
**Health Services**
**(CMHS)**

**Center for **
**Substance Abuse **
**Prevention**
**(CSAP)**

**Center for**
**Substance Abuse**
**Treatment**
**(CSAT)**

## Federal Partners Workgroup

| Department of Health and Human Services |  | Other Federal Partners |
| --- | --- | --- |
| AoA | NIH/NIDA | Department of Agriculture
Department of Defense |
| ACF | NIH/NIMH | Department of Education |
| AHRQ | OS/ASPE | Department of Housing and Urban Development |
| CDC | OS/OCR | Department of Justice |
| CMS | OS/OD | Department of Labor |
| HRSA | OS/OPHS | Department of Transportation |
| IHS | SAMHSA | Department of Veterans Affairs |
|  |  | Social Security Administration |

## Provides a model for shared responsibility at State and local levels.
Features the five principles around which the New Freedom Commission on Mental Health framed its work, cross-walked with the six goals of the Commission’s final report.
Describes the "state of success" for each principle.
Highlights current activities and proposes Year 1 action steps for each principle.

- Features the five principles around which the New Freedom Commission on Mental Health framed its work, cross-walked with the six goals of the Commission’s final report.
- Describes the "state of success" for each principle.
- Highlights current activities and proposes Year 1 action steps for each principle.

**Federal Action Agenda: First Steps**

## Two beautiful Hmong sisters from Menasha, WI, in elaborate Hmong clothing. This photo was taken shortly before a dance performance in Appleton, WI.

- Photo by Jeff Lindsay,
- Appleton, WI

## We cannot for a moment believe that knowledge has reached its final goal or the present constitution of society is perfect.... Whatever may be the limitations which trammel inquiry elsewhere, we believe the great State of Wisconsin should encourage that continual fearless sifting and winnowing by which alone truth can be found. 

- ―A statement made by the regents of the University of Wisconsin, as quoted by Zona Gale in *These United States* (1924).

## What Challenges Lie Ahead?

- Workforce development
- Measures of effectiveness and accountability

-   Financing

## Selected National Outcome Measures (NOMs)

- Decreased mental illness symptomatology/improved functioning1
- Increased/retained employment (adults); return to/retention in school (children)1
- Increased stability in family and living conditions
- 1Developmental

## What Challenges Lie Ahead (cont.)?

- Alignment of mental health and substance abuse approaches
- Leadership

## SAMHSA’s Treatment Improvement Protocol (TIP) 42

- Available free from SAMHSA at
*http://store.health.org/catalog*/

## Implementation Resource Kitswww.mentalhealth.samhsa.gov

**Implementation Resource Kits***www.mentalhealth.samhsa.gov*

- Co-occurring Disorders: Integrated Dual Disorders Treatment
- Illness Management & Recovery
- Medication Management  Approaches in Psychiatry
- Assertive Community Treatment
- Family Psychoeducation
- Supported Employment

## National Registry of Effective Programs and Practices (NREPP)http://modelprograms.samhsa.gov

**National Registry of Effective Programs and Practices (NREPP)***http://modelprograms.samhsa.gov*

## Co-Occurring Center for Excellence http://coce.samhsa.gov/

## Services Offered http://coce.samhsa.gov

- Overview papers, technical reports, and other information resources
- Technical assistance
- Cross-training
- Meetings and conferences
- Pilot evaluation of the Performance Partnership Grant (PPG) measure

## Wisconsin: fertile ground for innovations in behavioral health care. On, Wisconsin! Thank you.

- Iowa County, WI. Photo courtesy of USDA
- Natural Resources Conservation Service.

**Wisconsin: fertile ground for innovations in behavioral health care. On, Wisconsin! Thank you.**