Adapting Integrated Dual Disorders Treatment for Inpatient Settings

Abstract

ABSTRACT Integrated Dual Diagnosis Treatment (Drake et al.), an Evidence-Based Practice designed for persons with co-occurring mental illness and substance use disorders, was developed for delivery in outpatient settings and has been implemented widely in community mental health centers. Until recently, inpatient services compatible with IDDT were not available for dually diagnosed individuals who experienced psychiatric hospitalization at the onset of illness or over the course of treatment. For those individuals receiving outpatient IDDT, hospitalization could mean a disruption to gains painstakingly achieved in the community. Historically, inpatient psychiatric treatment has not been integrated with treatment for substance use nor has it been delivered by staff with expertise in both disorders. An initiative spearheaded by the Ohio Department of Mental Health (ODMH) and the Ohio Substance Abuse and Mental Illness Coordinating Center of Excellence (SAMI CCOE) to transfer the demonstrated value and success of the original outpatient IDDT model to the inpatient setting began close to three years ago. Building on the experience of some pioneering Ohio inpatient SAMI programs (Hurst, Neuzil et al, in preparation), and the experience of the SAMI CCOE and ODMH, a collaborative workgroup developed an IDDT Inpatient Adaptation protocol and fidelity index that has since been piloted at a number of sites in Ohio's Integrated Behavioral Healthcare System (IBHS). A work in progress, the IDDT Inpatient Adaptation is an important step toward providing consistent and continuous care to persons with co-occurring disorders across service delivery settings.