Addressing co-occurring disorders in the Empire State

Researchers estimate that less than 10% of the population with co-occurring mental health and substance use conditions in New York State receive evidence-based treatment for both. With a $3.2 million grant from the New York State Health Foundation, the new Center of Excellence for the Integration of Care (CEIC) aims to have a dramatic impact on that number.

Specifically, the goal of the four-year grant, awarded to National Development and Research Institutes, Inc., is to have CEIC improve the capability of New York State’s 1,223 licensed mental health and substance abuse outpatient treatment centers to conduct screenings and assessments for co-occurring disorders as well as provide evidence-based treatments. Through a combination of training, technical assistance, and the creation of learning communities, CEIC intends to substantially increase the use of screening tools and integrated evidence-based treatments statewide.

“We know so much more about what works than we did 10 years ago,” explains Stanley Sacks, PhD, a clinical research psychologist and CEIC’s director. “The literature is clear that traditional training alone is not sufficient.”

CEIC began work two months ago on an assessment of clinics’ co-occurring disorder capability. That effort is being followed by regional leadership forums to develop and refine an implementation plan. Those groups will help develop local learning collaboratives, whose members will meet once a month for peer-to-peer training. Curricula and online learning modules will be available on CEIC’s Web site (under development).

Several issues have led to the failure to identify and treat co-occurring conditions notes New York State Health Foundation President and CEO James Knickman, PhD. For example, he points out that the two types of treatment are reimbursed from different financial streams, and the cultures of the two types of clinics are different.

The foundation stepped in to provide funding because its leaders were impressed by the strong commitment to cooperation shown by Michael Hogan, PhD, commissioner of the New York State Office of Mental Health, and Karen Carpenter-Palumbo, commissioner of the state Office of Alcoholism and Substance Abuse Services.

“Historically these two agencies worked at 90-degree angles from each other, but these two leaders share the same vision to work on this problem, so the stars are aligned for real change,” Dr. Knickman says.

For people coming into mental health and substance abuse clinics with co-occurring conditions, “It ought to be the expectation, not the exception, that both are taken care of,” he adds. “We’re spending a lot of money on care. Let’s do it right.”

David Raths is a freelance writer.