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"This book emphasizes the importance of coordinating care among the health care professionals involved in a patient's addiction treatment and includes a plan for executing and assessing the success of the system. Drawing on three decades of experience helping practitioners, managers, administrators, and funders understand and implement this treatment, Dr. Hemphill discusses the history and integration of coordinated care, and details how it works in practice from the medical and business perspectives. He outlines a model that encourages the expansion of detection systems and stresses the importance of behavioral health treatment in addiction treatment centers which has the benefit of reducing treatment costs and enhancing care management. Resources are included for assessing organizational readiness, monitoring outcomes, and suggestions for continuous improvement to ensure a seamless transition, leading to better outcomes, patient engagement, and worker job satisfaction. This book offers innovative solutions that any healthcare professional practicing addiction and substance abuse can utilize to ensure optimal care"--
Each year, more than 33 million Americans receive health care for mental or substance-use conditions, or both. Together, mental and substance-use illnesses are the leading cause of death and disability for women, the highest for men ages 15-44, and the second highest for all men. Effective treatments exist, but services are frequently fragmented and, as with general health care, there are barriers that prevent many from receiving these treatments as designed or at all. The consequences of this are seriousâ€"for these individuals and their families; their employers and the workforce; for the nation's economy; as well as the education, welfare, and justice systems. Improving the Quality of Health Care for Mental and Substance-Use Conditions examines the distinctive characteristics of health care for mental and substance-use conditions, including payment, benefit coverage, and regulatory issues, as well as health care organization and delivery issues. This new volume in the Quality Chasm series puts forth an agenda for improving the quality of this care based on this analysis. Patients and their families, primary health care providers, specialty mental health and substance-use treatment providers, health care organizations, health plans, purchasers of group health care, and all involved in health care for mental and substanceâ€"use conditions will benefit from this guide to achieving better care.
Behavioral health conditions, which include mental health and substance use disorders, affect approximately 20 percent of Americans. Of those with a substance use disorder, approximately 60 percent also have a mental health disorder. As many as 80 percent of patients with behavioral health conditions seek treatment in emergency rooms and primary care clinics, and between 60 and 70 percent of them are discharged without receiving behavioral health care services. More than two-thirds of primary care providers report that they are unable to connect patients with behavioral health providers because of a shortage of mental health providers and health insurance barriers. Part of the explanation for the lack of access to care lies in a historical legacy of discrimination and stigma that makes people reluctant to seek help and also led to segregated and inhumane services for those facing mental health and substance use disorders. In an effort to understanding the challenges and opportunities of providing essential components of care for people with mental health and substance use disorders in primary care settings, the National Academies of Sciences, Engineering, and Medicine's Forum on Mental Health and Substance Use Disorders convened three webinars held on June 3, July 29, and August 26, 2020. The webinars addressed efforts to define essential components of care for people with mental health and substance use disorders in the primary care setting for depression, alcohol use disorders, and opioid use disorders; opportunities to build the health care workforce and delivery models that incorporate those essential components of care; and financial incentives and payment structures to support the implementation of those care models, including value-based payment strategies and practice-level incentives. This publication summarizes the presentations and discussion of the webinars.
Integrated care incorporates behavioral and physical health services into primary care and specialty medical environments. These models of care are patient-centered. population focused, and delivered by a multidisciplinary team of medical professionals. This book is practical, office-based, comfortably accessible, and intended for mental health professionals, primary care and medical specialists, and professional health students, residents, and other professionals working in integrated care environments.
All across the United States, individuals, families, communities, and health care systems are struggling to cope with substance use, misuse, and substance use disorders. Substance misuse and substance use disorders have devastating effects, disrupt the future plans of too many young people, and all too often, end lives prematurely and tragically. Substance misuse is a major public health challenge and a priority for our nation to address. The effects of substance use are cumulative and costly for our society, placing burdens on workplaces, the health care system, families, states, and communities. The Report discusses opportunities to bring substance use disorder treatment and mainstream health care systems into alignment so that they can address a person's overall health, rather than a substance misuse or a physical health condition alone or in isolation. It also provides suggestions and recommendations for action that everyone-individuals, families, community leaders, law enforcement, health care professionals, policymakers, and researchers-can take to prevent substance misuse and reduce its consequences.
People with mood disorders often have simultaneous problems with addiction, and those with substance abuse problems are especially susceptible to mood disorder. The treatment of such patients can be particularly complicated, and many receive treatment for only one of their disorders. In this book, fourteen clinicians discuss the extent of the problem, methods of assessment, typical courses, and treatments—including both psychotherapy and pharmacotherapy. They address the all-too-frequent necessity of proceeding with treatment before a clear diagnosis is known, and they claim that distinguishing between primary and secondary disorders is initially less critical than previously assumed. Contending that clinicians treating comorbid mood / substance problems must be both more flexible and more watchful than those treating either disorder alone, the authors also describe various models of care. Throughout the book, they provide differing points of view on such issues as the value of pharmacotherapy for those still abusing psychoactive substances. Written for those who treat addictions, including counselors, clergy, and employee assistance staff, as well as for traditional mental health professionals, Integrated Treatment for Mood and Substance Use Disorders is an invaluable reference for any clinician who works with dually diagnosed clients. -- Edward V. Nunes, Columbia University and the New York State Psychiatric Institute
Integrated Treatment for Co-Occurring Disorders addresses a complex client population, which presents service providers with significant professional challenges. Underlying personality disorders compromise treatment effectiveness for medical, other psychiatric, or trauma services, as well as the ability these individuals have in adhering to probation, parole, or court-ordered treatment requirements. A co-occuring substance use disorder amplifies the difficulties experienced by personality-disordered individuals, exacerbates the precarious nature of their relationships, and raises the skill level needed by service providers attempting to help them. There can be significant professional satisfaction in working effectively with the interplay of addiction and disorders of personality. The book brings focus to the specifics of assessment and treatment for this type of co-occurring disorder and suggests that greater adaptability, fewer self-sabotaging behaviors, and an abstinent lifestyle are all possible. Recovery from both disorders is the journey these individuals take toward greater maturation, reliable impulse control, and coping skills that are not dependent upon the evasion of the demands of living or use of substances to manage stress or uncomfortable affect. Recovery is possible, and service providers can assist these clients on their path to wellness.
This valuable resource prepares graduate-level students in social work and other helping professions to provide integrated behavioral health services in community-based health and mental healthcare settings. Responding to the increasing prevalence of behavioral health issues in the general U.S. population and the resulting additional responsibilities for social workers and health professionals, this textbook describes the latest evidence-based practices and interventions for common behavioral health disorders as well as issues related to suicide, violence, substance use, and trauma. Detailed case studies help illustrate the effects of a range of interventions, inviting readers to consider how best to implement behavioral health assessment and treatment practices that are evidence-based, trauma-informed, and recovery-oriented. In addition to outlining integrated behavioral health service models and assessment tools, chapters address specific topics such as: Public health approaches to addressing interpersonal violence Intersections of social, behavioral, and physical health Achieving recovery and well-being from behavioral health disorders Motivating clients to achieve and maintain recovery from addiction Stage-based treatments for substance use disorders Cognitive behavioral approaches to treating anxiety and depressive disorders Evidence-based approaches to treating the effects of trauma and PTSD Integrated Behavioral Health Practice equips graduate students and health professionals alike to provide sensitive and informed interprofessional care for patients and families while consistently engaging in practices that emphasize recovery and well-being.
This comprehensive clinical handbook provides virtually everything needed to plan, deliver, and evaluate effective treatment for persons with substance abuse problems and persistent mental illness. From authors at the forefront of the dual disorders field, the book is grounded in decades of influential research. Presented are clear guidelines for developing integrated treatment programs, performing state-of-the-art assessments, and implementing a wide range of individual, group, and family interventions. Also addressed are residential and other housing services, involuntary interventions, vocational rehabilitation, and psychopharmacology for dual disorders. Throughout, the emphasis is on workable ways to combine psychiatric and substance abuse services into a cohesive, unitary system of care. In a convenient large-size format, the volume includes reproducible assessment forms, treatment planning materials, and client handouts.
Problems stemming from the misuse and abuse of alcohol and other drugs are by no means a new phenomenon, although the face of the issues has changed in recent years. National trends indicate substantial increases in the abuse of prescription medications. These increases are particularly prominent within the military, a population that also continues to experience long-standing issues with alcohol abuse. The problem of substance abuse within the military has come under new scrutiny in the context of the two concurrent wars in which the United States has been engaged during the past decade-in Afghanistan (Operation Enduring Freedom) and Iraq (Operation Iraqi Freedom and Operation New Dawn). Increasing rates of alcohol and other drug misuse adversely affect military readiness, family readiness, and safety, thereby posing a significant public health problem for the Department of Defense (DoD). To better understand this problem, DoD requested that the Institute of Medicine (IOM) assess the adequacy of current protocols in place across DoD and the different branches of the military pertaining to the prevention, screening, diagnosis, and treatment of substance use disorders (SUDs). Substance Use Disorders in the U.S. Armed Forces reviews the IOM's task of assessing access to SUD care for service members, members of the National Guard and Reserves, and military dependents, as well as the education and credentialing of SUD care providers, and offers specific recommendations to DoD on where and how improvements in these areas could be made.