Psychiatric care management for chronic addictive disorders: conceptual framework

Coexisting mental and addictive disorders are common, and service systems are not well configured to treat them. Psychiatrists frequently feel lacking in skills to address both the addictive disorder and the mental illness. Although programs for treating "dual disordered" patients have been under development, specialized programs are likely to provide treatment for only a minority of patients. Furthermore, many patients either do not respond to them or simply refuse to participate. This article describes care management, a clinical approach that can be applied to coexisting disorders by any practitioner. Care management complements rehabilitation treatment and completes the continuum of care.