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Implementing Residential Integrated Treatment for Co-occurring Disorders.

Shari A McKee¹, Grant T Harris, Catherine A Cormier

¹Research Department, Waypoint Centre for Mental Health Care, Penetanguishene, Ontario, Canada.

Journal of Dual Diagnosis

|August 27, 2013

Summary

Implementing integrated treatment for co-occurring substance abuse and psychiatric disorders in a residential program improved patient outcomes and clinician morale. This evidence-based approach proved cost-effective, benefiting patients, staff, and the hospital.

Keywords:

co-occurring disorders implementation integrated treatment mental illness substance abuse

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Area of Science:

Addiction Psychiatry
Clinical Psychology
Healthcare Management

Background:

Effective treatments for co-occurring substance abuse and psychiatric disorders are known, but implementation in clinical practice remains challenging.
Evidence-based practice recommendations exist, yet their integration into daily healthcare services faces significant hurdles.

Purpose of the Study:

To describe the successful implementation of integrated treatment for co-occurring disorders within a small residential program.
To evaluate the transformation of a traditional addiction service into a 3-month integrated treatment program.

Main Methods:

A 3-month manualized integrated treatment program was developed, with clinicians receiving new training and ongoing supervision.
155 individuals with co-occurring disorders participated; data collected included client background, substance abuse, quality of life, mental health, self-esteem, and satisfaction.
Fidelity to the treatment model, participant knowledge/skill acquisition, clinician morale, attitudes toward evidence-based practices, staff turnover, and costs were assessed.

Main Results:

86 completers showed significant mental health improvement, enhanced knowledge/skills, high self-esteem, and program satisfaction.
High program fidelity, clinician morale, and positive attitudes toward evidence-based practices were observed.
The integrated program achieved the lowest per-inpatient day cost among hospital units.

Conclusions:

Evidence-based integrated treatment can be successfully implemented with fidelity in routine clinical settings, benefiting all stakeholders.
The presence of a scientist-practitioner to lead implementation was identified as a critical success factor.
Future research will examine long-term substance use and quality of life outcomes.