August 31, 2005

Building Bridges: Co-Occurring Mental Illness and Addiction: Consumers and Service Providers, Policymakers, and Researchers in Dialogue

The U.S. Department of Health and Human Services: Substance Abuse and Mental Health Services Administration writes in this article, published in August 2005, the growing number of persons with co-occurring mental and substance use disorders in the United States has precipitated a crisis. In 2002, Charles G. Curie, Administrator of the Substance Abuse and Mental Health Services Administration (SAMHSA) within the U.S. Department of Health and Human Services (DHHS), announced that addressing the needs of persons with co-occurring disorders had become one of the highest priorities for the agency. The crisis has been exacerbated by previously established separate systems of care for mental health and addictions. The two systems of care have different approaches to (1) identifying key symptoms, (2) making assessments or diagnoses, (3) deciding between quite disparate treatment approaches, and (4) figuring out which State block grant funding category should be used to obtain coverage and reimbursement for services. The systems challenge consumers and service providers alike, and, in some cases, create divisions between providers and consumers.

The Center for Mental Health Services (CMHS), within SAMHSA, has been given the lead in implementing the policies to improve the coordination of treatment and services identified by President George Bush's New Freedom Commission on Mental Health. The Commission's Final Report highlights the importance of convening participatory dialogues -a process that CMHS has used since 1997 to bring together consumers of mental health services and professional service providers. In 2003, CMHS created a dialogue between consumers with co- occurring mental health and substance use concerns and service providers, policymakers, and researchers. This report summarizes the meeting and the recommendations made by the participants.