Question

What is a co-occurring disorder? Describe this diagnosis and summarize the challenges a behavioral health provider may have when working with this population. Please Cite The Answer

Answer 1

• The coexistence of both a mental health and a substance use disorder is referred to as co-occurring disorders.Co-occurring disorders were previously referred to as dual diagnoses.For example, a person may be abusing a narcotic and also have bipolar disorder.
• People with mental health disorders are more likely than people without mental health disorders to experience an alcohol or substance use disorder. Co-occurring disorders can be difficult to diagnose due to the complexity of symptoms, as both may vary in severity.
• In many cases, people receive treatment for one disorder while the other disorder remains untreated. This may occur because both mental and substance use disorders can have biological, psychological, and social components. Other reasons may be inadequate provider training or screening, an overlap of symptoms, or that other health issues need to be addressed first.
• In any case, the consequences of undiagnosed, untreated, or undertreated co-occurring disorders can lead to a higher likelihood of experiencing homelessness, incarceration, medical illnesses, suicide, or even early death.
  
• People with co-occurring disorders are best served through integrated treatment. With integrated treatment, practitioners can address mental and substance use disorders at the same time, often lowering costs and creating better outcomes. Increasing awareness and building capacity in service systems are important in helping identify and treat co-occurring disorders. Early detection and treatment can improve treatment outcomes and the quality of life for those who need these services.
• Successful strategies with important implications for clients with COD include interventions based on addiction work in contingency management, cognitive-behavioral therapy (CBT), relapse prevention, and motivational interviewing.
• Primary health care providers (physicians and nurses) have historically been the largest single point of contact for patients seeking help with co-occurring disorders. Physicians and nurses are uniquely qualified to manage life-threatening crises and to treat medical problems related and unrelated to psychiatric and substance-use disorders.
• Because they are in contact with such large numbers of patients, they have an exceptional opportunity to screen and identify patients with co-occurring disorders. At that point, the person with COD can be referred for appropriate services in the proper setting.
• Many residential treatment programs have regulations precluding clients from speaking with providers outside their program, thus making it difficult for providers to monitor the progress of their clients in substance abuse treatment.
  
• Providers also face the challenge, that heavy caseloads and time constraints make maintaining regular contact with substance abuse treatment service providers impractical.
• Providers reported that confidentiality concerns and substance abuse treatment agency policies concerning disclosure of client information also stymie efforts to coordinate care.