Information about Concurrent Disorders

What are concurrent disorders?

Concurrent disorders (CD for short) generally describes a situation in which a person experiences a psychiatric disorder and either a substance use disorder and/or a gambling disorder. It is important to keep in mind that there are many different kinds of problems that are covered by these various terms (psychiatric disorder etc); as a result, CD presents itself in many different forms.

For example, someone living with schizophrenia who has problems with cannabis use has a concurrent disorder, and so does a person who has problems with alcohol use and has a clinical depression. Treatment approaches for each person would be different.

Other terms for concurrent disorders

Other terms used over the years to describe the occurrence of both problems include:  dual disorders, dual diagnosis, co-morbidity, and co-occurring substance abuse disorders and mental disorders These terms will still be found in publications and on web sites. In Ontario, the term dual diagnosis applies to people with developmental disabilities and psychiatric disorders. In the United States and in the international literature, dual diagnosis and dual disorders are most commonly used; although recently the phrase "co-occurring disorders" has been used to refer to clients diagnosed with psychiatric disorders and substance use disorders. 

CAMH  programs/services

There is a Concurrent Disorders Program at the Centre for Addiction and Mental Health in Toronto, which offers consultation, assessment and treatment, all on an outpatient basis, for individuals with co-occurring addiction and mental health problems.  Staff also provide clinical consultation to addiction and mental health providers around Ontario. In addition, CAMH as a whole has committed to building CD treatment capacity in all of its clinical programs over the next several years. The expertise that CAMH is continuing to develop in this area is meant to serve as a core resource to assist in CD capacity building throughout the province. 

Throughout Ontario, CAMH Project Consultants, Addiction and Mental Health System Planning Consultants, and Education and Publishing Consultants work closely with local/ regional planning bodies and service providers in a variety of capacities to improve services for people with concurrent disorders. There are a number of CD Priority Knowledge Exchange projects currently under development.

CD Resources

Program Development staff work with clinicians, consultants and researchers from CAMH and across Canada to develop publications and courses that translate innovations, evidence-based practice and clinical experience into practical information for clients and their families, health professionals and the general public.

• Beyond the Label
  An Educational Kit to Promote Awareness and Understanding of the Impact of Stigma on People Living with Concurrent Mental Health and Substance Use Problems (PDF only)
• Concurrent Substance Use and Mental Health Disorders: An Information Guide
  This guide is for people with concurrent disorders and for their families. It is also for anyone who wants basic information about concurrent disorders, their treatment and their management.

• Treating Concurrent Disorders: A Guide for Counsellors
  Preface and Introduction
  If you work with clients who have substance use or mental health problems, you are undoubtedly already working with people who have concurrent disorders. If you are committed to understanding and working with clients as whole persons, then you need to understand what these problems are, how they co-occur and how you can help...With this book, our goal is to take information about concurrent disorders beyond academic and scientific discourse, and to make it accessible to a wider range of readers. We hope that counsellors across a diverse range of services will be better able to work with this client population, and that people with co-occurring substance use and mental health problems will get the comprehensive care they need.
  

Links to other sources of CD information

• Progress Place's Double Recovery Program - This program offers those with mental illness, who also struggle with alcohol/drug addiction, safe and anonymous support through informal peer-based meetings. All groups are facilitated by staff who are themselves in recovery. Double Recovery hosts several weekly 12-step discussion meetings at Progress Place and throughout downtown Toronto.
  http://www.progressplace.org/static/community.htm  
   
• Health Canada -- Best Practices: Concurrent mental health and substance abuse disorders
  http://www.hc-sc.gc.ca/hecs-sesc/cds/pdf/concurrentbestpractice.pdf
   
• Concurrent Disorders listserv
  CD-L@PDOMAIN.UWINDSOR.CA]
   
• Report to Congress On The Prevention and Treatment of Co-occurring Substance Abuse Disorders and Mental Disorders -- Substance Abuse and Mental Health Services Administration, U.S. Department of Health and Human Services < http://www.samhsa.gov/reports/congress2002/>
   
• United States Department of Health and Human Service's Substance Abuse and Mental Health Services Administration's Strategies for Developing Treatment Programs for People With Co-occurring Substance Abuse and Mental Disorders (PDF file)
  http://www.nccbh.org/cooccurringreport.pdf 
   
• The Centre for Substance Abuse Treatment's Dual Disorders Special Topic http://www.treatment.org/Topics/dual.html 
   
• The National GAINS Centre for People with Co-occurring Disorders in the Justice System's Working Together for Change: Co-occurring Mental Health and Substance Abuse Disorders Among Youth Involved in the Juvenile Justice System
  http://xxx.xxx
   
• Kathleen Sciacca's Dual Diagnosis Website
  http://users.erols.com/ksciacca/ 
   
• Australia's MIDAS web site (Mental Illness with Problematic Drug or Alcohol Use)
  http://www.swsahs.nsw.gov.au/areaser/Midas/default.asp 
   
• Australia's New South Wales Office of Drug Policy's Discussion Paper and Service Delivery Guidelines http://www.druginfo.nsw.gov.au/druginfo/Dual.html  
   
• National Alliance for the Mentally Ill's Dual Diagnosis: Mental Illness and Substance Abuse http://www.nami.org/helpline/dualdiagnosis.htm 
   
• Report to Congress On The Prevention and Treatment of Co-occurring Substance Abuse Disorders and Mental Disorders -- Substance Abuse and Mental Health Services Administration, U.S. Department of Health and Human Services < http://www.samhsa.gov/reports/congress2002/>   
   

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