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Science and Service

Co-Occurring Disorders Programs

2007 Winners

Scioto Paint Valley Mental Health Center
Criminal Justice Substance Abuse Mental Illness Assertive Community Treatment (SAMI/ACT) Re-entry Team
937-981-7702 or 740-775-1260

In operation since 1965, Scioto Paint Valley Mental Health Center provides a full array of community-based outpatient mental health and substance abuse services to more than 10,000 individuals annually. Scioto Paint Valley Mental Health Center's five county service area is rural and geographically large, extending over 3,598 square miles with a population of approximately 225,000 individuals. Services provided by the Center are CARF accredited and certified by the Ohio Department of Mental Health and/or the Ohio Department of Drug and Alcohol Services.

In 2002 the Center met with community stakeholders to identify what forensic services were most needed and requested in our communities. After much collaboration it was decided the Center would establish a team to serve individuals meeting all of the following criteria: ages 17 to 25; dually diagnosed with a substance abuse disorder and a quadrant four mental health disorder; involvement with the criminal justice system; and returning from secure confinement to Highland or Fayette Counties. Following training with the Ohio SAMI Coordinating Center of Excellence in the utilization of the New Hampshire Dartmouth Integrated Dual Disorder Treatment (IDDT) Model, the Criminal Justice SAMI/ACT Re-entry Team began serving clients in October 2003.

In 2006 after much success utilizing the IDDT Model, the Center expanded services to include the Assertive Community Treatment Model (ACT), increased the case load to 40, expanded the age range to 40 and added 3 members to the team. The team works diligently to help clients re-enter their community as productive citizens by helping them address their substance abuse and mental health problems and in assisting them to find gainful employment and to access other community resources.

The Mental Health Center of Greater Manchester
Integrated Dual Disorders Treatment (IDDT)

The Mental Health Center of Greater Manchester in New Hampshire has been serving people who experience problems with mental illness for 47 years through a comprehensive system of services. Last year we served over 9,000 individuals, including 3,000 people with severe and/or persistent mental illness. We are the largest community mental health center in the state and the largest provider of outpatient behavioral health services in New Hampshire, with a staff of over 300.

People diagnosed with severe mental illness have a lifetime prevalence of substance abuse disorders of between 40%-60% compared to a 17% rate for the general population. In the late 1980s in response to unmet consumer needs for help with co-occurring disorders, this agency formed a distinct treatment team that adopted the principles of the Integrated Dual Disorders Treatment (IDDT) practice. The team matched the demand for more assertive outreach efforts to consumers who did not easily or consistently engage with services. Our efforts to monitor the outcomes from the IDDT program over the years have shown that we could significantly impact consumer outcomes in such areas that include: movement to less intensive "levels of care"; reduced levels of homelessness; higher measures of income; increased community functioning; improved housing status; and higher levels of sobriety. Sustaining our high fidelity IDDT services is critical and includes participation and keeping up-to-date with ongoing IDDT research, conducting regular internal and external monitoring of our practice, and responding to areas that IDDT fidelity assessments identify as in need of improvement.

Integrated Dual Disorders Treatment (IDDT)

Thresholds assists and inspires people with severe mental illnesses to reclaim their lives by providing the supports, skills and successful encouragement they need to achieve hopeful and successful futures. As Illinois' oldest and largest psychiatric rehabilitation center, the agency manages 30 service locations and more than 75 housing facilities in the Chicagoland area, and serves almost 7,000 people each year. The agency provides a comprehensive program of mental health services, including psychiatric rehabilitation, outreach programs, housing, employment services, educational advancement, independent living skills, and special programs such as its Integrated Dual Disorders Treatment Program.

Outcome data showed troubling treatment and service delivery issues for people with psychiatric and co-occurring substance use disorders, contributing to the high rates led to use of the Integrated Dual Disorder Treatment (IDDT) by Thresholds. To create an excellent environment in which evidence-based practices can thrive, Thresholds has: created positions dedicated to IDDT; integrated quality assurance, research, and training in monitoring the process outcomes of the practice; set up a steering committee; and changed human resources policy to ensure that IDDT continues to be faithfully implemented. The integration of the quality assurance, research, and training departments around fidelity reviews are perhaps the most important infrastructural change Thresholds has made. The integration of these departments improves the quality of fidelity reviews and trainings, both of which are keys to sustaining quality of care. In addition, the Program Director's performance is now assessed, in part, on the program's IDDT fidelity score. Outcome data indicate Thresholds' provision of IDDT benefits both the city of Chicago and individual consumers by reducing homelessness and jail days and increasing employment for individuals managing the dual disorders.

Ventura County Behavioral Health Division
Ventura County Health Care Agency.
Integrated Dual Diagnosis Treatment (IDDT)

Ventura County Behavioral Health (VCBH) in Ventura County, California is dedicated to relieving suffering and enhancing recovery from mental illness and substance abuse through leadership in prevention, intervention, education and policy advocacy. The agency's commitment is to best science, best service, and best outcome.

Two years ago, VCBH implemented Integrated Dual Diagnosis Treatment (IDDT) in two of the five outpatient clinics through use of the SAMHSA IDDT Fidelity Scale. This scale describes the components of an evidenced-based treatment program for severely mentally ill substance abusing clients. The program has been rated on each component of the scale by outside evaluators from the California Institute of Mental Health (CIMH) and has received perfect scores on almost every component. In addition, VCBH has been collecting outcome measures to evaluate client response to treatment. Data analysis indicates that the IDDT program participation is related to positive outcomes such as reduction in severity of psychiatric symptoms, abstinence from abusive substances, reduction in psychiatric hospitalizations and incarcerations, and successful completion of client-centered treatment plan objectives.

Last Update: 9/21/2009