Assessment and Treatment of Patients with Coexisting Mental Illness and Alcohol and Other Drug Abuse Treatment Improvement Protocol (TIP) Series 9
[Front Matter]
[Title Page]
Assessment and Treatment of Patients with Coexisting Mental Illness and Alcohol and Other Drug AbuseTreatment Improvement Protocol (TIP) Series 9
U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES Public Health Service Substance Abuse and Mental Health Services Administration Center for Substance Abuse Treatment Rockwall II, 5600 Fishers Lane Rockville, MD 20857DHHS Publication No. (SMA) 95-3061 Printed 1994. Reprinted 1995.
This publication is part of the Substance Abuse Prevention and Treatment Block
Grant technical assistance program. All material appearing in this volume except
quoted passages from copyrighted sources is in the public domain and may be reproduced
or copied without permission from the Center for Substance Abuse Treatment
(CSAT) or the authors. Citation of the source is appreciated.
This publication
was written under contract number ADM 270-91-0007 from the Center for Substance
Abuse Treatment of the Substance Abuse and Mental Health Services Administration
(SAMHSA). Anna Marsh, Ph.D., and Sandra Clunies, M.S., served as the Government project
officers. Elayne Clift, M.A., Carolyn Davis, Joni Eisenberg, Mim Landry, and Janice
Lynch served as writers.
The opinions expressed herein are those of the
consensus panel participants and do not reflect the official position of CSAT or
any other part of the U.S. Department of Health and Human Services (DHHS).
No official support or endorsement of CSAT or DHHS is intended or should
be inferred. The guidelines proffered in this document should not be considered
as substitutes for individualized patient care and treatment decisions.
CSAT Treatment Improvement Protocols (TIPs) are prepared
by the Quality Assurance and Evaluation Branch to facilitate the transfer
of state-of-the-art protocols and guidelines for the treatment of alcohol
and other drug (AOD) abuse from acknowledged clinical, research, and administrative
experts to the Nation's AOD abuse treatment resources.
The dissemination
of a TIP is the last step in a process that begins with the recommendation
of an AOD abuse problem area for consideration by a panel of experts. These
include clinicians, researchers, and program managers, as well as professionals
in such related fields as social services or criminal justice.
Once
a topic has been selected, CSAT creates a Federal Resource Panel, with members
from pertinent Federal agencies and national organizations, to review the state
of the art in treatment and program management in the area selected. Recommendations
from this Federal panel are then transmitted to the members of a second group,
which consists of non-Federal experts who are intimately familiar with the topic.
This group, known as a non-Federal Consensus Panel, meets in Washington
for 3 days, makes recommendations, defines protocols, and arrives at agreement
on protocols. Its members represent AOD abuse treatment programs, hospitals,
community health centers, counseling programs, criminal justice and child welfare
agencies, and private practitioners. A Chair for the panel is charged with responsibility
for ensuring that the resulting protocol reflects true group consensus.
The next step is a review of the proposed guidelines and protocol by a third
group whose members serve as expert field reviewers. Once their recommendations
and responses have been reviewed, the Chair approves the document for publication.
The result is a TIP reflecting the actual state of the art of AOD abuse
treatment in public and private programs recognized for their provision of high-quality
and innovative AOD abuse treatment.
This TIP, titled Assessment and
Treatment of Patients With Coexisting Mental Illness and Alcohol and Other Drug (AOD)
Abuse, provides practical information about the treatment of patients with dual
disorders, including the treatment of AOD patients with mood and anxiety disorders,
personality disorders, and psychotic disorders. This TIP also provides pragmatic information
about systems and linkage issues relative to the AOD and mental health treatment
systems. There is also a discussion about pharmacologic management of patients
with dual disorders.
This TIP represents another step by CSAT toward
its goal of bringing national leadership to bear in the effort to improve AOD
abuse treatment.
The Treatment Improvement Protocol Series (TIPs) fulfills CSAT's
mission to improve alcohol and other drug (AOD) abuse and dependency
treatment by providing best practices guidance to clinicians, program
administrators, and payers. This guidance, in the form of a protocol,
results from a careful consideration of all relevant clinical and health
services research findings, demonstration experience, and implementation
requirements. A panel of non-Federal clinical researchers, clinicians,
program administrators, and patient advocates employs a consensus
process to produce the product. This panel's work is reviewed and
critiqued by field reviewers as it evolves.
The talent, dedication, and hard work that TIPs panelists and reviewers
bring to this highly participatory process have bridged the gap between
the promise of research and the needs of practicing clinicians and
administrators. I am grateful to all who have joined with us to
contribute to advance our substance abuse treatment field.
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