Tools for the New Generation: Clinicians Must Be Prepared to Offer Appropriate Care for Co-Occurring Disorders

By Clark, H. Westley | Addiction Professional, July-August 2007 | Go to article overview

Tools for the New Generation: Clinicians Must Be Prepared to Offer Appropriate Care for Co-Occurring Disorders


Clark, H. Westley, Addiction Professional


Since the Substance Abuse and Mental Health Services Administration's National Treatment Plan effort of 2000, SAMHSA's Center for Substance Abuse Treatment (CSAT) has worked with the substance use disorder treatment field to address the needs of the next generation of clinical professionals. SAMHSA has continued to recognize the importance of workforce issues. There is one particular area of emphasis that SAMHSA believes should be of concern to the next generation of clinical professionals: co-occurring disorders.

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The co-occurrence of substance use and mental disorders within one individual presents a unique set of challenges for consideration by our next generation of clinical professionals. The behavioral health workforce must have a unique set of skills and training that demonstrates their working knowledge of mental health and substance use disorders as well as the interactions among those disorders and the ways in which each condition may affect the other. Data trends suggest that the existing behavioral health workforce is not prepared to meet the needs of persons in recovery with both substance abuse and mental health disorders.

SAMHSA recognizes that individuals enter the behavioral health field with different levels of expertise and experiences; however, it is imperative to establish a baseline of core competencies that addresses the unique needs of people with (and at risk for) co-occurring disorders. These competencies are needed to ensure that regardless of where an individual enters the behavioral health continuum of care (prevention/promotion/treatment), core standards of care are available within a substance abuse prevention/mental health promotion, substance abuse/mental health treatment, or relapse/recovery context.

Of the 5.2 million adults with both serious psychological disturbance and substance dependence or abuse (i.e., a substance use disorder), about half (47%) received mental health treatment or substance use treatment at a specialty facility in 2005. Of this group, approximately 8.5% received specialty treatment for both mental health and substance use disorders, indicating that more than 90% of all individuals needing treatment for a co-occurring disorder received either no treatment or inappropriate treatment. This highlights the compelling need for core competencies for addressing co-occurring disorders within the behavioral workforce.

Recruitment needs

In addition, it has been well documented that members of ethnic/racial groups are underrepresented in the workforce compared to the numbers of minorities needing services. …

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