The New Chronic Patient and the System of Community Care

Caton, Carol L. M.

doi:10.1176/ps.32.7.475

Cited by 81 publications

(47 citation statements)

References 21 publications

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“…While the conclusion itself is not surprising, it is striking that this conclusion continues to be just as salient today as it was when it was first reached over 25 years ago. [2][3][4] Since that time, numerous reports, reviews, and research have documented well and extensively the uneasy relationship that exists between mental health services and services for persons with addictions. [5][6][7][8][9][10][11][12][13][14][15][16] Consistent epidemiological and service utilization data collected during this same period have shown that mental illnesses and addictions co-occur within the same person as frequently as they exist independently of one another.…”

Section: Introductionmentioning

confidence: 99%

The Concept of Recovery as an Organizing Principle for Integrating Mental Health and Addiction Services

Davidson

White

2007

J Behav Health Serv Res

143

119

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Despite a range of long-standing historical, political, ideological, professional, structural, and practical barriers, there has been, and continues to be, a clear consensus that integration between mental health and addiction services is sorely needed and long overdue. This paper focuses on one dimension of the challenge of integration from among the several - the conceptual - and proposes the construct of recovery as an organizing principle for bridging the divide between the two domains. After reviewing briefly the parallel history of the two traditions and their shared need for transformation to a recovery orientation, the authors offer an integrated model of recovery for persons with co-occurring disorders. They then derive from this model the underlying values, guiding principles, key strategies, and essential ingredients of recovery-oriented systems of care that comprise a common approach across both addictions and mental illness, offering a strengths-based solution to achieving integration where pathology-focused approaches have failed.

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Section: Introductionmentioning

confidence: 99%

The Concept of Recovery as an Organizing Principle for Integrating Mental Health and Addiction Services

Davidson

White

2007

J Behav Health Serv Res

143

119

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“…For this population, substance use disorders are common (1–5) and are associated with multiple adverse outcomes, including treatment dropout (23), recurrent hospitalization (24,25), violence (26), homelessness (27), incarceration (28), relapse (29), and victimization (30), as well as medical problems such as HIV and hepatitis (31). The course of substance use disorders in this population tends to be chronic and relapsing (32,33).…”

mentioning

confidence: 99%

Substance Use Disorder Among People With First-Episode Psychosis: A Systematic Review of Course and Treatment

Wisdom

Manuel²,

Drake³

2011

Psychiatric Services

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Objective People experiencing a first episode of psychosis frequently have co-occurring substance use disorders, usually involving alcohol and cannabis, which put them at risk for prolonged psychosis, psychotic relapse, and other adverse outcomes. Yet few studies of first-episode psychosis have addressed the course of substance use disorders and the re sponse to specialized substance abuse treatments. Methods The authors searched MEDLINE, PsycINFO, and other medical databases for English-language articles published between 1990 and 2009. Included studies addressed two research questions. First, do some clients become abstinent after a first episode of psychosis without specialized substance abuse treatments? Second, for clients who continue to use substances after a first episode of psychosis, does the addition of specialized substance abuse treatment enhance outcomes? Results Nine studies without specialized substance abuse treatment and five with specialized substance abuse treatment assessed the course of substance use (primarily cannabis and alcohol) after a first episode of psychosis. Many clients (approximately half) became abstinent or significantly reduced their alcohol and drug use after a first episode of psychosis. The few available studies of specialized substance abuse treatments did not find better rates of ab stinence or reduction. Conclusions Experience, education, treatment, or other factors led many clients to curtail their substance use disorders after a first episode of psychosis. Specialized interventions for others need to be developed and tested.

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“…Since the problem of dual diagnosis became clinically apparent in the early 1980s [1,2], researchers have established several consistent findings. First, co-occurrence is common, with lifetime substance abuse affecting approximately 50% of individuals with schizophrenia [3].…”

Section: Introductionmentioning

confidence: 95%

Managing comorbid schizophrenia and substance abuse

Drake

Mueser

2001

Curr Psychiatry Rep

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Effective treatments for co-occurring schizophrenia and substance abuse have emerged over the past 15 years. They involve integration and melding of mental health and substance abuse treatments, helping people to acquire the skills and supports they need to manage both illnesses and to pursue functional goals, and a comprehensive, long-term approach to recovery. Further research is needed to refine specific interventions and to improve knowledge regarding implementing integrated treatment settings in routine mental health programs.

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The New Chronic Patient and the System of Community Care

Cited by 81 publications

References 21 publications

The Concept of Recovery as an Organizing Principle for Integrating Mental Health and Addiction Services

The Concept of Recovery as an Organizing Principle for Integrating Mental Health and Addiction Services

Substance Use Disorder Among People With First-Episode Psychosis: A Systematic Review of Course and Treatment

Managing comorbid schizophrenia and substance abuse

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