Care In Mental Health Substance Use

Estimates indicate that as many as 1 in 4 Americans will experience a mental health problem or will misuse alcohol or drugs in their lifetimes. These disorders are among the most highly stigmatized health conditions in the United States, and they remain barriers to full participation in society in areas as basic as education, housing, and employment. Improving the lives of people with mental health and substance abuse disorders has been a priority in the United States for more than 50 years. The Community Mental Health Act of 1963 is considered a major turning point in America's efforts to improve behavioral healthcare. It ushered in an era of optimism and hope and laid the groundwork for the consumer movement and new models of recovery. The consumer movement gave voice to people with mental and substance use disorders and brought their perspectives and experience into national discussions about mental health. However over the same 50-year period, positive change in American public attitudes and beliefs about mental and substance use disorders has lagged behind these advances. Stigma is a complex social phenomenon based on a relationship between an attribute and a stereotype that assigns undesirable labels, qualities, and behaviors to a person with that attribute. Labeled individuals are then socially devalued, which leads to inequality and discrimination. This report contributes to national efforts to understand and change attitudes, beliefs and behaviors that can lead to stigma and discrimination. Changing stigma in a lasting way will require coordinated efforts, which are based on the best possible evidence, supported at the national level with multiyear funding, and planned and implemented by an effective coalition of representative stakeholders. Ending Discrimination Against People with Mental and Substance Use Disorders: The Evidence for Stigma Change explores stigma and discrimination faced by individuals with mental or substance use disorders and recommends effective strategies for reducing stigma and encouraging people to seek treatment and other supportive services. It offers a set of conclusions and recommendations about successful stigma change strategies and the research needed to inform and evaluate these efforts in the United States.

Mental health-substance use is a complex interrelation, with equally complex implications for individuals and their families, health professionals and society. Although its international recognition as an issue of critical importance is growing, clear guidance for professionals on mental health-substance use and its treatment is hard to find. The Mental Health-Substance Use series has been written to address this need, concentrating on concerns, dilemmas and concepts that impact on the life and well-being of affected individuals and those close to them, and the future direction of practice, education, research, services, interventions, and treatment. This first book outlines the specific health issues, experiential aspects, treatment options and wider implications of mental health-substance use, as well as defining the field, through contributions from international experts and practitioners. This Introduction and the subsequent volumes will challenge concepts and stimulate debate, exploring all aspects of the development in treatment, intervention and care responses, and the adoption of research-led best practice. They are essential reading for mental health and substance use professionals, students and educators.

The Mental Health-Substance Use series provides clear guidance for professionals on this complex and increasingly recognised field. It concentrates on the concerns, dilemmas and concepts that impact on the life and well-being of affected individuals and those close to them, as well as the future direction of practice, education, research, services, intervention, and treatment. This volume is primarily about caring for individuals and families who turn to professionals at a time when their lives are unmanageable alone, but is also concerned with the care that these professions extend to their own members. It contends that these issues are closely interrelated, with appropriate communication and support being key to both. Its chapters draw from a variety of theories and treatments to provide practical advice on the challenge of providing appropriate care tailored to a wide scope of individuals and families. The volumes in this series are designed to challenge concepts and stimulate debate, exploring all aspects of the development in treatment, intervention and care response, and the adoption of research-led best practice. They are essential reading for mental health and substance use professionals, students and educators.

Second in a series of publications from the Institute of Medicine's Quality of Health Care in America project Today's health care providers have more research findings and more technology available to them than ever before. Yet recent reports have raised serious doubts about the quality of health care in America. Crossing the Quality Chasm makes an urgent call for fundamental change to close the quality gap. This book recommends a sweeping redesign of the American health care system and provides overarching principles for specific direction for policymakers, health care leaders, clinicians, regulators, purchasers, and others. In this comprehensive volume the committee offers: A set of performance expectations for the 21st century health care system. A set of 10 new rules to guide patient-clinician relationships. A suggested organizing framework to better align the incentives inherent in payment and accountability with improvements in quality. Key steps to promote evidence-based practice and strengthen clinical information systems. Analyzing health care organizations as complex systems, Crossing the Quality Chasm also documents the causes of the quality gap, identifies current practices that impede quality care, and explores how systems approaches can be used to implement change.

All across the United States, individuals, families, communities, and health care systems are struggling to cope with substance use, misuse, and substance use disorders. Substance misuse and substance use disorders have devastating effects, disrupt the future plans of too many young people, and all too often, end lives prematurely and tragically. Substance misuse is a major public health challenge and a priority for our nation to address. The effects of substance use are cumulative and costly for our society, placing burdens on workplaces, the health care system, families, states, and communities. The Report discusses opportunities to bring substance use disorder treatment and mainstream health care systems into alignment so that they can address a person's overall health, rather than a substance misuse or a physical health condition alone or in isolation. It also provides suggestions and recommendations for action that everyone-individuals, families, community leaders, law enforcement, health care professionals, policymakers, and researchers-can take to prevent substance misuse and reduce its consequences.

This book shows mental health providers how to assess and treat substance use in medical settings. Clinical health psychologists often encounter patients needing interventions for substance use, yet rarely do practitioners receive specialized training in this area. Psychological Treatment of Medical Patients With Harmful Substance Use is designed for mental health providers in medical settings who need the knowledge and skills to assess and treat conditions relevant to substance use. This book is especially useful for mental health providers who treat adult medical outpatients for whom substance use is not their primary presenting problem. The authors clarify the distinction between nonharmful and harmful substance use, describe the signs and symptoms of substance use disorders, epidemiology, current models denoting biological and socio-cultural causes, and contributing factors (with an emphasis on cardiac, cancer, women's health, and primary care settings). They offer best-practice assessment strategies, and psychological, self-help and pharmacological treatments. Chapters also describe assessment and intervention for conditions that are often comorbid with substance use, including depression, anxiety, and sleep dysregulation, as well as treatment for family members who are dealing with a loved one's harmful substance use, relapse prevention and continuing care.

This guide was created to promote the early identification of children and adolescents with mental health and substance use problems as well as to provide guidance, tools, and resources for early identification-including a compendium of the most developmentally, culturally, and environmentally appropriate screening instruments. SAMHSA developed the guide using the input of the members of the Federal/National Partnership* (FNP) Early Identification Workgroup, chaired by representatives from the Centers for Disease Control and Prevention (CDC) and the Health Resources and Services Administration (HRSA).

Co-occurring Mental Illness and Substance Use Disorders: A Guide to Diagnosis and Treatment provides a clinically detailed, evidence-based, and exhaustive examination of a topic rarely plumbed in psychiatry texts, despite the fact that co-occurring mental illness and substance use disorders are common. The authors argue for a more holistic and integrated approach, calling for clinicians to tactfully but persistently evaluate patients for a broad range of co-occurring disorders before determining appropriate treatment. Focusing on a substance use disorder in isolation, without determining whether another psychiatric disorder is co-occurring, can doom treatment efforts, and the reverse also is true. To help clinicians keep the big picture in mind, the book is organized around 18 cases, each of which addresses a particular diagnostic skill (e.g., assessment), group of disorders commonly comorbid with substance use disorders (e.g., PTSD, eating disorders), specific treatment (e.g., pharmacological interventions), or special population (e.g., adolescents). This case-based approach makes it easy for readers to understand strategies and master transferable techniques when dealing with their own patients. Because the initial face-to-face sessions are especially important with this patient population, the book includes chapters on the diagnostic assessment and the initial interview, as well as offering interviewing tips throughout to help the clinician develop the necessary care and skill in this arena. Also included is a chapter on integrating motivational interviewing into the treatment. Each of the 18 cases stands alone, allowing the reader flexibility in using the text. For example, the 18 cases and discussions can be read sequentially, or as needed, depending on the reader's special interest or current need. The book also features chapters on how to effectively work with patients whose disorders might be affecting other members of a patient's family, since the likelihood of a successful outcome is enhanced if an integrated treatment plan is developed for their co-occurring disorders. The questions that accompany each chapter can be used as an organizational tool prior to reading or to test knowledge and comprehension afterward. The text is completely up-to date and provides DSM-5 diagnostic information essential to each case. Co-occurring Mental Illness and Substance Use Disorders: A Guide to Diagnosis and Treatment offers a straightforward approach to people with complicated presentations, offering mental health clinicians the skills they require to effectively assess, diagnose, and treat these patients and their families.