Recovery Strategies for Combined Mental Illness & Substance Use

Disorders

Consumer Education and Support Statewide Call-In: April 24, 2008

Welcome!

Thank you to all who have joined in for today’s call! Instructions for CEU’s for today’s call

– Fax Sign-In Sheets to:– Josephine Brodbeck, FAX (309) 693-5101– Include information on where to send the certificates

Schedule for future calls– May 29th – Crisis Plans: Making Choices for Difficult Times– June 26th - How to Develop Inclusive Agency-Based Advisory

Councils

Objectives for Today’s Call

1. Participants will learn how common co-occurring mental illness and substance use disorders are

2. Participants will learn about the things that contribute to substance use among people with mental illnesses

3. Participants will learn about things that have helped people become motivated to reduce or abstain from use and strategies that have worked in recovery

4. Participants will have an opportunity to ask questions and offer suggestions regarding these topics

Guidelines for Today’s Call

All Speakers Will Use Person-First Language All Acronyms Will Be Spelled Out and Defined Diverse Experiences Will Be Heard and

Validated

Personal Testimonials of Recovery:Jerry, Elizabeth, and Earl

What activities do you do, to give your days structure and to help you stay connected to positive, helpful people?

How does your housing play a role in your recovery?

How has peer support played a role in your recovery?

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How common are substance use disorders in people with mental illnesses?

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10

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60

% of respondents

with substance use disorder

Genpop

Schiz Bipolar Majdep

OCD Panic

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How frequent is mental illness in people with substance use disorders?

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10

20

30

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50

60

70

Community

In community, 24.4% have mental illness

In institutions, 55% have mental illness

In substance abuse treatment, 65% have mental illness

Why do people with psychiatric disorders use substances?

To cope emotionally with a mental illness To self-medicate To avoid stigma To have something to do To feel normal and like part of society To overcome victim status by seeking challenge or

excitementAlverson et al. (2000)

Why do people with co-occurring disorders stop using substances ?

To change one’s life To respond to wishes of a spouse, family,

friends, or for the sake of the children To get or hold a job, or seek an education To survive or improve health To stop the increasing desire for more drugs To feel better

Alverson et al. (2000)

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Does Sobriety Lead to a More Satisfying Life or Does a More Satisfying Life Lead to Sobriety?

Studies show that people with dual disorders regularly relapse on substances as they work toward attaining sobriety

The attainment of sobriety occurs over months and years

And is enhanced by successful engagement in the positive life factors

Alverson et al., CMHJ 2000

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Positive Life Factors That Promote Recovery

A regular, enjoyable activity that provides structure to one’s day and provides a sober social network

Decent safe and stable housing A loving, caring relationship with someone sober,

who accepts the person’s mental illness A positive therapeutic relationship, including regular

contacts, with a mental health professional

Alverson et al., CMHJ (2000)

Are Separate Mental Health and Substance Abuse Treatments by

Different Providers Effective?

Due to complicating features of the co-occurring disorder, persons served by programs designed to treat only a single disorder tend to experience: Higher dropout rates “Non-adherence” to interventions Being “kicked out” of services Poor communication with providers Poor outcomes

Drake, Mueser, Brunette, McHugo (2004)

What is Integrated Treatment?

Both psychiatric and substance use disorders are treated simultaneously, in one clinical setting, by one multidisciplinary team of clinicians

Drake, Mercer-McFadden, Mueser, McHugo, & Bond, 1998.

Does Integrated Treatment Help?

Controlled studies investigating the components of Integrated Treatment have demonstrated:

Decreased rates of substance use Improved psychiatric symptoms Decreased hospitalization rates Decreased arrest rates Improved housing stability Improved functional status Improvements in quality of life

Drake et al. (2001)

Does participation in self-help groups promote recovery?

Self-help groups offer social support and fellowship Groups are recommended for consumers in the active

treatment and relapse prevention stages.– DDA (Dual Disorders Anonymous) – DRA (Dual Recovery Anonymous)– AA (Alcoholics Anonymous)– NA (Narcotics Anonymous)– CA (Cocaine Anonymous)– DTR (Double Trouble in Recovery)

How Can I Find the ‘Right Fit’ When Looking for a Self-Help Group?

Check out meetings ahead of time Talk to the person chairing the meeting Ask what people at the meeting think about

medications

Osher and Kofoed (1989)

How Can I Get More Information?

12-step mutual support group format for people diagnosed with mental illness and chemical addictions

– Dual Recovery Challenges Circle: – www.recoverycircles.org

Research on the effectiveness of mutual support run solely and completely by people with mental health diagnoses and co-occurring substance use disorders

– www.professored.com – Click on “Publications,” then click on “Double Focus Mutual

Support”

How Can I Get More Information?

Integrated Dual Disorders Treatment (IDDT) Toolkit from the Substance Abuse and Metnal Health Services Administration (SAMHSA):

http://mentalhealth.samhsa.gov/cmhs/communitysupport/toolkits/cooccurring/

Information on IDDT for Consumers from SAMHSA:

http://mentalhealth.samhsa.gov/cmhs/communitysupport/toolkits/cooccurring/consumers.asp

Guidelines for Q & A

All Speakers Will Use Person-First Language All Acronyms Will Be Spelled Out and Defined Diverse Experiences Will Be Heard and

Validated Limit to One Question per Person, then Pass to

the Next Person Saying “Thank You” Indicates You Are

Finished With Your Question

Thank You!

Written Questions Can Be Sent To:– Tim Devitt, Director of Integrated Dual Disorders Treatment,

Thresholds, Inc.– tdevitt@thresholds.org – FAX: (773) 572-5290

– Nanette Larson, Director of Recovery Support Services, DHS/Division of Mental Health

– Nanette.Larson@illinois.gov – FAX: (309) 693-5101