Individuals with both psychiatric and addiction problems are referred to as having a dual diagnosis. This diagnosis is quite common. According to the Journal of the American Medical Association, 37 percent of those who abuse alcohol and 53 percent of those who abuse other drugs have at least one serious mental illness, most commonly depression, bipolar disorder, anxiety disorders, schizophrenia and personality disorders. In addition, 29 percent of individuals diagnosed with a mental illness abuse alcohol or other drugs.
Ideally, those with a dual diagnosis should be treated for both disorders simultaneously. However, the diagnosis can be difficult; symptoms of severe substance abuse closely mirror those of some psychiatric disorders. The first step to a correct diagnosis is medically supervised detoxification. Then the clinician can accurately determine what, if any, mental illness is present.
There is some controversy around the question of which problem came first and this controversy can hinder appropriate treatment. The structures of the mental health and the substance abuse treatment systems are usually quite separate, involving different points of access, funding streams, philosophies and treatment techniques. While dually diagnosed individuals need treatment for both, one system may view substance abuse as symptom of, or means of self-medicating, the underlying problem of mental illness and minimize the need for addiction treatment. The other system may see the mental illness as an offshoot of substance abuse and minimize the need for psychiatric treatment. Thus, many communities do not have an integrated system of care and the dually diagnosed person is left with a fractured and confusing avenue to recovery.
Fortunately, this is not the case in Washington County. L & P Services, the contract agency of the Washington County Behavioral Health Board, is certified by both the Ohio Department of Mental Health and the Ohio Department of Alcohol and Drug Addiction Services, offering a research-based, integrated treatment approach for persons with a dual diagnosis. While some counties are represented by separate Boards, one for mental health and one for addiction, the Washington County Behavioral Board is a combined Board. This, in combination with a combined contract agency, allows for greater efficiency in treatment. Recently the Ohio Department of Mental Health and the Ohio Department of Alcohol and Drug Addiction Services announced plans to merge in an effort to streamline service delivery and to more prudently appropriate the dwindling resources allocated to both Departments.
There is hope for recovery from co-occurring mental illness and addiction, but it takes courage, commitment and an effective treatment program. Helpguide.org offers the following fundamentals of effective treatment for a dual diagnosis:
The treatment addresses both the substance abuse problem and your mental health problem.
You share in the decision-making process and are actively involved in setting goals and developing strategies for change.
The treatment includes basic education about your disorder and related problems.
You are taught healthy coping skills and strategies to minimize substance abuse, cope with upset, and strengthen your relationships.
Peer support groups, such as Alcoholics Anonymous, Narcotics Anonymous and Circle of Hope (a local mental health peer support group) can be very helpful in maintaining recovery, receiving support and discussing challenges.
For more information about how to access these recovery opportunities, call the Washington County Behavioral Health Board at 374-6990.