Understanding the Implementation of Integrated Treatment for Concurrent Mental Health and Addiction Issues: A Qualitative Case Study

Abstract

In the late 1990s and early 2000s, co-occurring mental health and substance use problems (concurrent disorders) have become an increasingly debated topic within the Canadian addiction and mental health treatment systems. Historically, services for concurrent disorders have been provided separately and were often conducted by two different programs or organizations without sufficient coordination of care. These non-integrated treatment models have been widely criticized for poor treatment outcomes. In contrast to this, integrated treatment, which addresses both issues simultaneously, has been accepted as the most appropriate treatment available since it applies aspects of both mental health and addiction problems to its treatment programs. In this research study, I focused on this relatively new approach to the treatment of concurrent disorders, as I was interested in exploring how and why integration of treatment for mental health and substance use problems has become such a prevailing concept. I will provide an overview of a research project in which I examined how the implementation of integrated treatment occurred in “real-life” practice of two treatment programs at a large hospital in Toronto, Ontario. Multiple levels of integration—clinical, organizational, and systems—were taken into account when I designed my research project as a multiple qualitative case study. I used semi-structured interviews with key informants, analyses of organizational documents, as well as participant observations of administrative and clinical meetings to collect data.

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