Care of people with dual disabilities in the mental health system: Education vs. attitude rehabilitation

Abstract A significant proportion of persons presenting for mental health treatment has concurrent substance use disorders. Differentiation of the diseases is problematic, and the scope of the problem difficult to quantify The administrative separation of mental health from alcohol and drug treatment decades ago has resulted in MISA clients being denied service because of exclusionary criteria maintained by the distanced agencies. The individual might spend years bouncing between the systems, or might fall directly through the cracks between them, ending up untreated, on the streets, or in the penal system. In this article the author describes her experiences providing addictions training to clinicians in the Illinois mental health system, and observing the increasing integration of mental health and addictions care in this system.