Why Integrating Mental Health and Addiction Services is Hard and What to Do About It

Why Integrating Mental Health and Addiction Services is Hard
and What to Do About It

Keynote or Breakout

DESCRIPTION

Recovery in both addiction and mental illness is not always a smooth path.  Psychiatrists and other mental health clinicians can often view recovery and relapse for psychiatric disorders differently from addiction. This presentation will discuss what we really mean by recovery in addiction and mental health treatment.  It will invite participants to examine their attitudes about recovery and relapse; and the language and jargon we use in treatment. It will look at what “relapse” means in addiction and mental health and how to assess and treat flare-ups of patients’ addiction and/or mental health. It will discuss the discrepancy between what clinicians often say about recovery and relapse and what they actually do in treatment.

OBJECTIVES

Participants will

  1. Identify definitions, attitudes and dilemmas in recovery and relapse in co-occurring disorders.
  2. Discuss the discrepancy between concepts about recovery and relapse and actual clinical practice.
  3. Apply ways to improve consistency in dealing with recovery and relapse in co-occurring disorders treatment.

CONTENT OUTLINE

A. Identify definitions and dilemmas in recovery and relapse in co-occurring disorders

  • Definitions of recovery and relapse in addiction treatment
  • Definitions of recovery and relapse in mental health
  • Dilemmas: What to do about substance use while in treatment? Zero tolerance and transfer/discharge or allow the patient to remain in treatment? What to do in a relapse of depression, psychosis, mania or anxiety compared with substance disorder relapse?

B.  Discuss the discrepancy between concepts about recovery and relapse and actual clinical practice.

  • Inconsistencies between how recovery groups like Alcoholics Anonymous (AA) deal with ambivalence and relapse and how addiction treatment works with people with addiction
  • Discrepancies between how recovery and relapse are dealt with in mental health treatment versus addiction treatment
  • Origins of these different perspectives – abstinence oriented in mental health versus abstinence-mandated in addiction treatment

C.  Apply ways to improve consistency in dealing with recovery and relapse in co-occurring disorders treatment.

  • Changing attitudes about illness in mental health versus willful misconduct in addiction
  • Changing attitudes and practice to be abstinence-oriented, not abstinence-mandated
  • Relapse policies and a suggested policy and procedure for dealing with substance use in treatment
  • Increasing accountability in both addiction and mental health recovery