Recovery Strategies for Combined Mental Illness

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Recovery Strategies for Combined Mental Illness
Substance Use Disorders

• Consumer Education and Support Statewide Call-In
  April 24, 2008

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Welcome!

• Thank you to all who have joined in for todays
  call!
• Instructions for CEUs for todays call
• Fax Sign-In Sheets to
• Josephine Brodbeck, FAX [phone]
• Include information on where to send the
  certificates
• Schedule for future calls
• May 29th Crisis Plans Making Choices for
  Difficult Times
• June 26th - How to Develop Inclusive Agency-Based
  Advisory Councils

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Objectives for Todays Call

1. Participants will learn how common co-occurring
   mental illness and substance use disorders are
2. Participants will learn about the things that
   contribute to substance use among people with
   mental illnesses
3. Participants will learn about things that have
   helped people become motivated to reduce or
   abstain from use and strategies that have worked
   in recovery
4. Participants will have an opportunity to ask
   questions and offer suggestions regarding these
   topics

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Guidelines for Todays Call

• All Speakers Will Use Person-First Language
• All Acronyms Will Be Spelled Out and Defined
• Diverse Experiences Will Be Heard and Validated

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Personal Testimonials of RecoveryJerry,
Elizabeth, and Earl

• What activities do you do, to give your days
  structure and to help you stay connected to
  positive, helpful people?
• How does your housing play a role in your
  recovery?
• How has peer support played a role in your
  recovery?

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How common are substance use disorders in people
with mental illnesses?
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How frequent is mental illness in people with
substance use disorders?

• In community, 24.4 have mental illness
• In institutions, 55 have mental illness
• In substance abuse treatment, 65 have mental
  illness

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Why do people with psychiatric disorders use
substances?

• To cope emotionally with a mental illness
• To self-medicate
• To avoid stigma
• To have something to do
• To feel normal and like part of society
• To overcome victim status by seeking challenge or
  excitement
• Alverson et al. (2000)

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Why do people with co-occurring disorders stop
using substances ?

• To change ones life
• To respond to wishes of a spouse, family,
  friends, or for the sake of the children
• To get or hold a job, or seek an education
• To survive or improve health
• To stop the increasing desire for more drugs
• To feel better
• Alverson et al. (2000)

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Does Sobriety Lead to a More Satisfying Life or
Does a More Satisfying Life Lead to Sobriety?

• Studies show that people with dual disorders
  regularly relapse on substances as they work
  toward attaining sobriety
• The attainment of sobriety occurs over months and
  years
• And is enhanced by successful engagement in the
  positive life factors
• Alverson et al., CMHJ 2000

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Positive Life Factors That Promote Recovery

• A regular, enjoyable activity that provides
  structure to ones day and provides a sober
  social network
• Decent safe and stable housing
• A loving, caring relationship with someone sober,
  who accepts the persons mental illness
• A positive therapeutic relationship, including
  regular contacts, with a mental health
  professional
• Alverson et al., CMHJ (2000)

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Are Separate Mental Health and Substance Abuse
Treatments by Different Providers Effective?

• Due to complicating features of the co-occurring
  disorder, persons served by programs designed to
  treat only a single disorder tend to experience
• Higher dropout rates
• Non-adherence to interventions
• Being kicked out of services
• Poor communication with providers
• Poor outcomes
• Drake, Mueser, Brunette, McHugo (2004)

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What is Integrated Treatment?

• Both psychiatric and substance use disorders are
  treated simultaneously, in one clinical setting,
  by one multidisciplinary team of clinicians
• Drake, Mercer-McFadden, Mueser, McHugo, Bond,
  1998.

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Does Integrated Treatment Help?

• Controlled studies investigating the components
  of Integrated Treatment have demonstrated
• Decreased rates of substance use
• Improved psychiatric symptoms
• Decreased hospitalization rates
• Decreased arrest rates
• Improved housing stability
• Improved functional status
• Improvements in quality of life
• Drake et al. (2001)

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Does participation in self-help groups promote
recovery?

• Self-help groups offer social support and
  fellowship
• Groups are recommended for consumers in the
  active treatment and relapse prevention stages.
• DDA (Dual Disorders Anonymous)
• DRA (Dual Recovery Anonymous)
• AA (Alcoholics Anonymous)
• NA (Narcotics Anonymous)
• CA (Cocaine Anonymous)
• DTR (Double Trouble in Recovery)

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How Can I Find the Right Fit When Looking for a
Self-Help Group?

• Check out meetings ahead of time
• Talk to the person chairing the meeting
• Ask what people at the meeting think about
  medications
• Osher and Kofoed (1989)

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How Can I Get More Information?

• 12-step mutual support group format for people
  diagnosed with mental illness and chemical
  addictions
• Dual Recovery Challenges Circle
• www.recoverycircles.org
• Research on the effectiveness of mutual support
  run solely and completely by people with mental
  health diagnoses and co-occurring substance use
  disorders
• www.professored.com
• Click on Publications, then click on Double
  Focus Mutual Support

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How Can I Get More Information?

• Integrated Dual Disorders Treatment (IDDT)
  Toolkit from the Substance Abuse and Metnal
  Health Services Administration (SAMHSA)
• http//mentalhealth.samhsa.gov/cmhs/communitysuppo
  rt/toolkits/cooccurring/
• Information on IDDT for Consumers from SAMHSA
• http//mentalhealth.samhsa.gov/cmhs/communitysuppo
  rt/toolkits/cooccurring/consumers.asp

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Guidelines for Q A

• All Speakers Will Use Person-First Language
• All Acronyms Will Be Spelled Out and Defined
• Diverse Experiences Will Be Heard and Validated
• Limit to One Question per Person, then Pass to
  the Next Person
• Saying Thank You Indicates You Are Finished
  With Your Question

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Thank You!

• Written Questions Can Be Sent To
• Tim Devitt, Director of Integrated Dual Disorders
  Treatment, Thresholds, Inc.
• tdevitt_at_thresholds.org
• FAX [phone]
• Nanette Larson, Director of Recovery Support
  Services, DHS/Division of Mental Health
• Nanette.Larson_at_illinois.gov
• FAX [phone]

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