Increasingly, the psychiatric and drug counseling communities agree that both disorders must be treated at the same time. Early studies show that when mental illness and substance abuse are treated together, suicide attempts and psychotic episodes decrease rapidly.
Since dually diagnosed clients do not fit well into most traditional 12-step programs, special peer groups based on the principle of treating both disorders together should be developed at the community level. Individuals who develop positive social networking have a much better chance of controlling their illnesses. Healthy recreational activities are extremely important.
What's the first step in treatment?
The presence of both disorders must first be established by careful assessment. This may be difficult because the symptoms of one disorder can mimic the symptoms of the other. Seek referral to a psychologist or psychiatrist. Local NAMI affiliates are happy to refer families to mental health professionals their members recommend. (Call the NAMI HelpLine at 800/950-6264 for a local contact.)
Once a professional assessment has confirmed a dual diagnosis of mental illness and substance abuse, mental health professionals and family members should work together on a strategy for integrating care and motivating the adolescent.
What do model programs for treating mental illness and substance abuse look like?
There are a growing number of model programs. Support groups are an important component of these programs. Adolescents support each other as they learn about the negative role that alcohol and drugs has had on their lives. They learn social skills and how to replace substance use with new thoughts and behaviors. They get help with concrete situations that arise because of their brain disorder (mental illness). Look into programs that have support groups for family members and friends.
Reviewed by Patrick C. Friman, Ph.D., A.B.P.P., director of Clinical Services & Research, Father Flanigan's Boys' Home, and associate professor, Creighton University School of Medicine 10/98