What services are dedicated to the problem of dual diagnosis?
Services dedicated to the problem of dual diagnosis are facilities for people who suffer from both mental illness and substance abuse. Studies have clearly indicated that to recover fully, a user with comorbidity, needs treatment for both problems and focuses on only one of them does not ensure that the other is resolved the dedicated services to integrate care for dual diagnosis each problem, helping people admitted for both problems in a unique location, at the same time.
The dual diagnosis services include different forms of assistance ranging from drug therapy to support social welfare and also includes support for family members, and will as well run on money management and interpersonal relationships.
The personalized treatment has long-term prospects and can be initiated at any stage of admission. Positivity, hope and optimism are the foundations of integrated treatment.
It often happens that people with serious mental illness also have substance abuse problems?
There is a lack of information on the number of people with this comorbidity, but research has shown that it is very common.
As published in the report done by the JAMA (Journal of the American Medical Association):
- Approximately 50% of individuals with serious mental illness have a substance abuse problem.
- 37% of individuals who abuse alcohol and 53% of drug abusers also accuses least one serious mental illness.
- Of the people diagnosed with mental illness, 29% abused alcohol or drugs.
- The best available data on the frequency of comorbidity are drawn from two major surveys conducted in the U.S.: the ECA survey (area that collects epidemiological data) conducted between 1980 and 1984, and the National Survey on comorbità (NCS), conducted between 1990 and 1992. The results of the NCS and ECA survey indicate high incidence of comorbidity with substance abuse and mental disorders, as well as increasing the risk for people with substance abuse disorder or mental illness to develop comorbidity. For example, NCS found that:
- 42.7% of individuals with an addictive disorder in the twelve months he has had at least one mental disorder during the same year.
- 14.7% of individuals with a mental disorder in the twelve months has had, during the year, an addictive disorder. The ECA study found that individuals with serious mental disorders had higher risk of developing substance abuse disorders during their lifetime. Specifically:
- 47% of individuals with schizophrenia also had substance abuse disorders (probably more than four times compared to the rest of the population).
- 61% of individuals with bipolar disorder had a substance abuse (probably more than five times compared to the rest of the population).
Findings support the ongoing studies, and on better illustrated than in the past thinking it must be suitable for the development of a combined treatment of these diseases occur when the transactions are often not yet established.
What are the disadvantages of a coincidence in time between severe mental illness and substance abuse?
User, and a number of serious consequences. Black people are statistically guriyagiddaru violence, dual diagnosis, rather than hiring teams of the show, and tries to undergo more frequent treatment failure. The problems of the user's family, friends and business associates devolves.
Regarding health issues closely, having both a mental disorder and the problem of substance abuse often leads to a depletion of vital functions and greater likelihood of relapse. These users are constantly in and out of hospitals, and treatment programs sometimes do not have been lasting success.
Disease than people with a dual diagnosis of tardive dyskinesia (TD) and more likely to have a physical disability, and often experience mental episodes.
In addition, physicians, especially older adults, substance abuse and mental illness do not recognize the existence of the disease.
Look at the social problem of substance abuse relapse, people usually emerge from mental illnesses. In other words, the edge of their mental illness as a result of the use of drugs in areas where it can be accepted.
Having great difficulty developing social relationships, some people are more easily accepted by groups in which social relationships are based on drug use. Some may believe that being identified as a drug addict is more acceptable than being identified as a person with a mental illness.
Patients with dual diagnoses often are homeless or in prison.
It is estimated that 50% of homeless adults with serious mental illnesses have behavioral disorders due to substance abuse.
It was also estimated that 16% of those detained in prison have serious mental illness and substance abuse problems. Among inmates with mental disorders, 72% as well diagnosed with substance abuse.
Consequences for society directly stem from this reality.
Already the only treatment "back and forth" usually given to people with dual diagnosis is costly but not violent. In addition, users of crime or violence, without considering how they were treated unfairly, are dangerous and also costly for society.
People with double diagnosis are also at high risk of contracting AIDS, a problem that affects society as a whole. The costs increase even more when these people, as already seen that happen to people with dual diagnosis are more involved and further often in incidents of crime and holding periods. Without stable programs of integrated treatment, the cycle will continue.
Why an integrated approach to treat severe mental illnesses and substance abuse problems so important?
In spite of many studies that support its success, the integrated treatment is still not widely available to users people who are involved in a serious mental illness and also in substance abuse face problems of enormous proportions.
Services for Mental Health are not sufficiently prepared to deal with patients who have both problems. Often only one of two problems is identified. If both are approved, the individual can go back and forth between services for mental illness and those for substance abuse, or may be rejected by one of them. It fragmented and uncoordinated services create more problems for people with dual diagnosis.
Establish appropriate and integrated services for these users will not only make possible the recovery and improve overall health, but may enhance the effects that these disorders have on family, friends and society in general.
Helping them to take care, to look for work and home, developing a better social skill and judgment, we can begin to decrease some of the most threatening and costly societal problems: crime, HIV / AIDS, family violence, and more.
There is clear evidence that integrated treatment can be effective. For example:
Individuals with substance abuse disorders are much more likely to receive treatment if they have mental disorders.
Research shows that when people with dual diagnosis successfully pass the abuse of alcohol, their response is greatly increased.
With a continuous refinement in the study of dual diagnosis disorders, it is hoped to be on track to get to have improved treatment options and greater knowledge.
What does an effective integrated treatment?
Effective integrated treatment consists of medical professionals, who work in one environment (setting), providing appropriate treatment for both mental health and for substance abuse in a coordinated manner. Who cares about these people who control the actions are coordinated with each other, and users, therefore, receive consistent treatment, with no opposition between the interventions for mental health or substance abuse.
The approach, philosophy and recommendations are appropriate, and eliminated the need to consult other professionals.
Integrated treatment also requires that you realize that the Counseling for substance abuse counseling and traditional mental health have a different approach and must be reconciled in order to deal with dual diagnosis disorders.
Is not sufficient, for example, teach mode only to relate to a person with bipolar disorder. We must also study how to avoid relationships that are linked to substance abuse.
Operators should recognize that the denial of care is intrinsic to the problem that you propose.
Patients often do not have the perception of the seriousness and extent of the problem. Abstinence can be a goal of the program but should not be a prerequisite for starting treatment. If people with dual diagnosis can not fit in the local Self Help Groups of Alcoholics Anonymous or Narcotics Anonymous groups should be organized based on similar principles of Self Help.
People with dual diagnosis have to proceed with their own pace. Do not be a moralistic approach. Operators should communicate the knowledge of how difficult it is to solve a problem of dual diagnosis and encourage every small improvement. Must be given much attention to the whole social network that can serve as an important resource. Users should be given opportunities to socialize, have access to recreational activities and develop relationships with peers.
Their families should be offered information and support, teaching not to react with feelings of guilt or accusations, but taking them to be able to face two diseases interact.
What are the key factors in effective integrated treatment?
There are several key factors in an integrated treatment program.
The treatment can be approached in stages. The first step is to establish a relationship of trust between the user and the operator. This helps to motivate the user to learn the skills for active control of their emotions and focus on the objectives.
In addition, a relationship of trust supports the user to keep on track and avoid relapse. The program is customized for each individual.
Effective treatment includes motivational interventions, which, through education, support and counseling, helps make people able to recognize their goals and to learn self-management of the disease.
Of course, counseling is a key component of services for dual diagnosis. The counseling helps to develop replicable positive examples, as well as to promote cognitive and behavioral. The advice may be in the form of individual therapy, group, or family, or a combination of these.
The person's social support is crucial. The environment has a direct impact on his decisions and his mood, so users need help to develop positive relationships and eliminate negative behaviors.
The programs provide an integrated treatment effective in the long-term hospitalization in a community that can take several months or more probably a few years. The improvement is slow even with a program of intense treatment. However, this approach prevents relapses and enhances the benefits for the user.
To be effective, a treatment program for dual diagnosis must take into account the many aspects of life: stress management, social relationships, work, housing problem and activities. These programs address the problem of substance abuse and mental illness and provide solutions to both diseases simultaneously.
Finally, effective integrated treatment programs must be sensitive to cultural differences and characteristics of the person. The various social categories such as immigrants, the homeless, women with children and others should benefit from services tailored to their particular racial and cultural needs.
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