When a person has a mental health problem, chances are increased that he may also have a problem with substance abuse. And the same goes for those individuals suffering from an addiction, who have a greater likelihood of having an underlying mental health issue.

In Louisiana, statistics gathered from one area of the state show that 49 percent of the clients of the Office of Mental Health also have a co-occurring substance use disorder. Those statistics also show that 46 percent of the clients of the Office for Addictive Disorders have a psychiatric illness.

People who have both a mental illness and a substance abuse problem have complex needs that often impact every aspect of their lives.  As a group, they have more severe psychiatric symptoms, repeated hospitalizations and a variety of legal and social problems. Typically, these individuals receive services through two separate systems, for mental health and substance abuse, with little integration between the two.

A new initiative has been launched by the Department of Health to implement integrated services throughout the mental health and substance abuse service systems. The goal of this initiative is not the creation of another program for a particular target population, but rather to implement a fundamental change in the way the agencies do business throughout the system.

This effort to integrate treatment and coordinate responses to better serve citizens who have both a mental illness and a substance addiction is being led by the newly formed Behavioral Health Task Force. The Behavioral Health Task Force, composed of both community and agency leaders, was one of only 10 teams in the nation selected to attend a National Policy Academy on Co-Occurring Disorders, where members received specialized training and technical assistance about implementing integrated treatment services.

According to Dr. Cheryll Bowers Stephens, assistant secretary for OMH and member of the Behavioral Health Task Force, people who have a mental illness and a substance abuse disorder suffer from two primary illnesses, and each requires specialized treatment.

“Ideally, integrated treatment is delivered seamlessly by skilled, cross-trained clinicians and treatment teams,” Dr. Bowers-Stephens said. “It focuses on the whole person and addresses all areas of dysfunction. By combining the expertise of both substance abuse and mental health experts, we can bridge together the treatment service system to get positive results. This is the most effective way to enhance the lives of the clients and family members whom we serve.”

The effort is made possible through a Co-occurring State Incentive Grant that LDH received last year from the Substance Abuse and Mental Health Services Administration. The grant, which will pay $3.4 million over a five-year period, is designed to help states develop programs aimed at treating co-occurring disorders. Louisiana was one of only seven states in the nation to receive this grant.

A project coordinator for the grant began work in May. Tanya McGee serves as staff for the Behavioral Health Task Force and is using the grant to develop new treatment strategies.

Throughout the summer, McGee will travel to every region in the state to meet with staff from all local OAD and OMH offices, as well as the four human services districts, to learn about specific, local needs that must be met to implement integrated treatment. From this starting point, the project will lead to the development of local steering committees that will serve as the key decision-making bodies. The local committees will provide the infrastructure for planning, development and problem solving, and will assure appropriate administrative and operational oversight for the project at the local levels.

“Many regions and districts have already developed a steering committee that addresses the issues associated with the co-occurring population, so the agency will use this grant to build on the successes that have already been achieved,” McGee said.

The Behavioral Health Task Force is working with LDH staff to look at what can be done to implement statewide system changes for treatment. Three initiatives are already underway: development of a shared treatment database for OMH and OAD; program evaluation and outcome measurements; and common screening and assessment tools that can be adapted to treat co-occurring disorders.

The Behavioral Health Task Force is in the process of analyzing national data about successful treatment strategies, as well as exploring Medicaid funding options to support the continued efforts of integrated treatment.

“The continued work on the COSIG project will eventually result in better health outcomes for our clients,” said OAD Assistant Secretary Michael Duffy and member of the Behavioral Health Task Force. “With the hard work and preparation being done now, we will ensure a more effective, comprehensive program used to administer better treatment and care for those we serve.”