A leading researcher on dual diagnosis was often fond of saying that when treating a patient with behavioral illness, the presence of both a mental health and substance use condition should be the expectation, not the exception. Today that same assumption holds true when considering the competencies of programs that treat patients with behavioral health disorders.
The widely accepted ASAM Criteria governing level-of-care decisions in substance use treatment, from the American Society of Addiction Medicine, includes a standard calling for substance use treatment programs to be “co-occurring capable.” Not only should they expect most of their patients to enter treatment with both a substance use and mental health condition, they must be able to offer patients symptom support and to integrate these individuals’ substance use and mental health treatment needs.
According to the standard in the ASAM Criteria, addiction treatment programs should employ at least one staff member who is qualified to assess and triage mental health symptoms. In cases where patients might need more intensive mental health services than what the more addiction-focused provider can offer, programs should coordinate with external mental health providers. The standard does not require substance use treatment programs to offer skilled mental health treatment directly.
Capability in co-occurring disorders holds even greater importance now that competition for government funding in behavioral health has intensified. It’s rare these days to see any grant announcements at the national level that don’t address both substance use and mental health in their application language. While the Substance Abuse and Mental Health Services Administration (SAMHSA) maintains separate block grant funding pools to the states for substance use and mental health, pressure toward more blended funding continues among some stakeholders.
Even the Department of Health and Human Services’ (HHS’s) much-discussed request in June for public comment on the most successful strategies for combating the “chronic disease of addiction” asked for guidance on improving access to “effective prevention, treatment and recovery interventions for addiction, mental illness and co-occurring substance use and mental disorders.”
The request for comment, supporting the effort to promote the Trump administration’s Great American Recovery Initiative, also cites recent federal agency guidance that called for greater coordination among Medicaid, substance use, mental health and child welfare agencies at the state level, with a focus on identifying effective early interventions for youths.
The message is clear: Treatment providers and the government agencies that oversee them are being asked to shed siloed approaches to care and acknowledge patients’ complex needs in their programming.
Technology to support integrated treatment remains essential to these organizations’ success. A powerful EHR solution allows providers to offer the most comprehensive level of care to those they serve. Sigmund’s AURA solution, designed by behavioral health experts, offers seamless care coordination and sound decision support. Have a conversation with us to see how we can enhance your care integration capability.
