Integrated Dual Disorders Treatment
“Dual Diagnosis” or “Dual
Disorders” refers to patients suffering from both
serious mental illnesses such as schizophrenia, bipolar
disorder and major depression, and substance use disorders
such as alcohol, cocaine or other drug abuse or dependence.
It is estimated that between 40 and 80%
of patients with a serious mental illness will abuse alcohol
or drugs at some time. Individuals with these combined
conditions are often the most difficult to treat, most
likely to relapse, and represent the highest percentage
of psychiatric patients requiring hospitalization.
The Ohio
Substance Abuse/Mental Illness Coordinating Center of
Excellence (SAMI CCOE) is a partnership between the
Department of Psychiatry and the Mandel School of Applied
Social Sciences at Case Western Reserve University. One
of seven CCOE’s established by the Ohio Department
of Mental Health to promote “evidence-based practices”
in community mental health services, the SAMI CCOE’s
mission is to promote and sustain Integrated Dual Disorder
Treatment (IDDT) for persons suffering co-occurring serious
psychiatric and substance use disorders.
IDDT is a multidisciplinary, team-centered
approach, which emphasizes simultaneous and integrated
treatment of both substance abuse and serious mental illness.
IDDT combines assertive community outreach, comprehensive
services delivery, stable living environments, employment
and stage-wise treatment of the dual diagnosis patient.
Dr. Robert Drake and colleagues at Dartmouth University,
who have demonstrated fidelity to the model as a key feature
to its success, developed the IDDT model.
The SAMI CCOE provides clinical training,
consultation, program development, design and implementation
support, while conducting research into program fidelity
and outcomes and the success of model adaptations to meet
the needs of special populations. In its two years of
operation the SAMI CCOE has expanded from supporting 8
to more than 20 IDDT programs around the state, and in
developing an adaptation of the IDDT model for inpatient
services and for homeless populations.
The SAMI CCOE is co-directed by Dr. Robert
Ronis, Vice Chair for Education and Director of Public
Psychiatry in the Department of Psychiatry at University
Hospitals of Cleveland, and Dr. Lenore Kola, Dean of Graduate
Studies and Associate Professor at the Mandel School of
Applied Social Sciences.
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