Introduction to the special issue: Overview of misa dual diagnosis and treatment

Attention to the issue of the concurrent diagnosis of mental illness and alcoholism or substance abuse has grown dramatically over the past two decades. There are now a host of articles in the clinical literature on the topic; see for example, the Annotated Bibliography (1997) of the Co-occurring Mental and Substance Disorder (Dual Diagnosis) Panel, funded by the federal Center for Mental Health Services (CMHS). Over the past few years, federal agencies including CMHS, the Center for Substance Abuse Treatment (CSAT), the Center for Substance Abuse Prevention (CSAP), and the National Institute for Mental Health (NIMH), have funded research, service projects, conferences, or consensus reports on the subject. Federal funding for dual diagnosis treatment pilot projects has been made available to counties, cities, states, hospitals, community agencies, universities, and other entities. A number of state governments have similarly funded either limited or statewide dual diagnosis service projects (see for example, Drake et al., 1992; Godley, 1995; Mehr, 1999; Thacker & Tremaine, 1989). The impact of a concurrent diagnosis of mental illness (or emotional disorder) and alcoholism or substance abuse on a variety of other factors, problems, or variables has been the subject of increasing attention. These variables or factors include homelessness, adolescence, violence, HIV status, managed care systems, severity of mental illness, gender, integration of treatment, family support, peer groups, self help,