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Implementation of Integrated Dual Disorder Treatment in Routine Veterans Health Administration Settings.

Angela L Rollins1,2,3, Johanne Eliacin1,2,3, Marina Kukla1,2

  • 1VA HSR&D Center for Health Information and Communication, Veterans Health Indiana, 1481 W. 10th Street (11-H), Indianapolis, IN 46202, USA.

International Journal of Mental Health and Addiction
|June 10, 2026
PubMed
Summary
This summary is machine-generated.

Integrated dual disorder treatment effectively coordinates care for severe mental illnesses and substance use disorders. Key factors for successful implementation in Veterans Health Administration settings include staff training, leadership support, and program adaptability.

Keywords:
CostsImplementationMental healthSubstance use disorder

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Area of Science:

  • Implementation Science
  • Psychiatry
  • Public Health

Background:

  • Integrated dual disorder treatment (IDDT) coordinates care for severe mental illnesses (SMI) and comorbid substance use disorders (SUD).
  • IDDT is evidence-based but faces implementation challenges in routine practice, particularly within the Veterans Health Administration (VHA).

Purpose of the Study:

  • To identify critical factors influencing the implementation of IDDT within VHA settings.
  • To document the costs associated with IDDT implementation efforts.

Main Methods:

  • Qualitative study evaluating IDDT in four VHA programs across two medical centers.
  • Utilized interviews and observations, with initial coding based on the Consolidated Framework for Implementation Research (CFIR).
  • Cost analysis conducted at one VHA site.

Main Results:

  • Perceived usefulness of the model, ongoing case-based coaching, staff receptiveness to stage-wise interventions, leadership support (team and management levels), and model adaptability were critical factors.
  • Implementation costs were relatively modest.

Conclusions:

  • Findings provide insights for future IDDT implementation within the VHA.
  • Results are relevant to broader challenges in implementing complex mental health interventions in diverse service settings.