Develop a Shared Vision for an Integrated System
The key to a successful integrated mental health and substance abuse system is developing a shared vision before integration begins. The mental health and substance abuse systems may co-exist well, but each has its own distinct culture and language. If these differences are not recognized when system integration begins, the process may be difficult. Bridging cultural gaps can be thorny for practitioners unfamiliar with the operations, approaches, knowledge base and treatment philosophies of other systems of care.
An ideal integrated system is based on a common vision.
Planners need to agree on system goals and objectives, and how to measure effectiveness. A shared vision guides the development of programs and policies, and the allocation of scarce resources.
The first step in promoting integration efforts is to articulate and disseminate the shared vision. A shared vision can be thought of as a set of principles that recognizes and validates the role of mental health systems, programs, and approaches along with addiction systems, programs, and approaches.
Stakeholders need to be involved.
Create the shared vision by allowing stakeholders to develop and share their goals for the integrated system. Significant stakeholder involvement and input from the grassroots are essential for the vision to be meaningful and effective.
Stakeholders who participate in the development of a shared vision work hard to address differences in philosophy, culture, and terminology between systems.
Stakeholders who are active in the process tend to appreciate the differences in agency culture. For example:
- How each partner operates
- Different communication styles
- Greater understanding of each other's role
- Appreciation for each others' approach to serving their individuals with co-occurring disorders
Shared visions can also lay the basis for future key documents, like policy directives, state charters, and logic models. There is much value in revisiting the shared vision periodically to ensure it remains relevant, especially when changes occur.
Workforce development activities promote a shared vision.
Cross-training or shared curricula can help practitioners from each system understand their different infrastructures, operating procedures, values, and cultures. Activities like these build personal relationships, increase teamwork across systems, and foster respectful working relationships.
Interagency training around common interests and needs can be particularly valuable. Training can promote dialogue to explore common ground, including values. Interactive training with breaks and meals can help build new relationships and refresh existing ones. In addition, training on the "ins and outs" of each other's systems is essential.
Here are a few examples of how to create and promote a shared vision:
- Use a "wiki space" to create a consensus document, allowing stakeholders to provide input for the basis of the shared vision.
- Sponsor a meeting of supervisors systems that includes modules on co-occurring disorders to promote dialogue across systems.
- Create a shared curriculum for practitioners within different systems.
Resources and Links
Connecticut Department of Mental Health and Addiction Services Commissioner's Policy Statement and Implementing Procedures
Connecticut Commissioner's Policy Statement outlining the goals and principles of the State's approach to COD.
Virginia's Co-Occurring Disorders Initiative Action Plan, featuring its vision, mission, and plan for disseminating its vision and mission to develop a shared vision.
COCE Overview Paper 3 — Overarching Principles To Address the Needs of Persons With Co-Occurring Disorders
The 12 overarching principles to guide systemic and clinical responses to people with COD
Substance Abuse Treatment for Persons With Co-Occurring Disorders. Treatment Improvement Protocol (TIP) Series 42 — Chapter 2: Definitions, Terms, and Classification Systems for Co-Occurring Disorders
Comprehensive collection of COD terms and language