Many individuals simultaneously suffer from mental illness, problem alcohol and drug use, and other medical or physical disorders, resulting in enormous individual suffering and societal costs. Common comorbidities include mood disorders compounded with substance abuse, chronic pain with depression and/or drug abuse, anxiety disorders with cancer, panic disorder with asthma, hepatitis C with alcohol dependence, and schizophrenia with post-traumatic stress disorder. Such comorbidities
may fluctuate across the lifespan in a cyclical pattern of heightened risk, onset, intervention, recovery, and relapse, challenging the utility of the traditional “acute care”
model of service delivery for these conditions. Furthermore, the understanding of the combined service needs of persons at risk for developing, or currently suffering from, co-occurring disorders, and the mechanisms by which such needs can be met effectively, is relatively limited. Given these issues surrounding co-occurring conditions, the U.S. Department of Health and Human Services sponsored the conference “Complexities of Co-Occurring Conditions: Harnessing Services Research to Improve Care for Mental, Substance Use, and Medical/Physical Disorders,” a collaborative effort among the National Institutes of Health (National Institute of Mental Health, National Institute on Drug Abuse, National Institute on Alcohol Abuse and Alcoholism), Substance Abuse and Mental Health Services Administration, Agency for Healthcare Research and Quality, and Health Resources and Services Administration.
Attended by health services researchers, care providers, administrators, policymakers, and members of the media, the conference showcased theoretical models and research findings on the organization, management, and financing of prevention, treatment, and aftercare services to enhance access, quality, and cost-effectiveness of care for individuals at risk for, or suffering from, co-occurring conditions. Many of these topics were covered in four plenary sessions: Complexities of Co-Occurring Conditions, Service Access and Utilization, Quality and Financing of Co-Occurring Services, and Health Disparities. Fifteen presentations from the plenary sessions are highlighted here.
Plenary Session 1: Complexities of Co-Occurring Conditions
Science and Service: Opening Pathways to Better Mental Health
Richard K. Nakamura, Ph.D.
The Co-Occurring Matrix for Mental and Addictions Disorders
Richard K. Ries, M.D.
Co-Occurring Disorders: The “Z-axis”
Richard Saitz, M.D., M.P.H.
Addressing Co-Occurring Conditions: A Provider’s Perspective
Joan E. Zweben, Ph.D.
Plenary Session 2: Service Access and Utilization
Alcohol Use Disorders and Co-Occurring Conditions
Ting-Kai Li, M.D.
Preventing Co-Occurring Disorders: Prospects and Opportunities
J. David Hawkins, Ph.D.
Complexities of Co-Occurring Disorders: State Agency Perspective
Renata J. Henry, M.Ed.
Access to Best Practices for Co-Occurring Disorders: Research and Practice Partnerships
Constance Weisner, Dr.P.H., M.S.W.
Plenary Session 3: Quality and Financing of Co-Occurring Services
Advancing Excellence in Health Care: Complexities of Co-Occurring Conditions
Helen Burstin, M.D., M.P.H.
Measuring What Counts—AND—Making it Count for Quality
Constance Horgan, Sc.D.
Five Dimensions of Quality
David Rosenbloom, Ph.D.
Paying for Performance—Sounds Good…. But What Performance Are WE Paying For?
Nancy Wolff, Ph.D.
Plenary Session 4: Health Disparities
Understanding & Treating Co-Occurring Conditions: A Major Research Priority for NIDA
Nora D. Volkow, M.D.
A Socio Cultural Framework for Mental Health and Substance Abuse Service Disparities Research with Multicultural Populations
Margarita Alegria, Ph.D.
Drug-Involved Women and HIV: Co-Occurring Risk Factors
Nabila El-Bassel, Ph.D.