Dual diagnosis: substance-related and psychiatric disorders

One of the most challenging situations facing mental health professionals is intervening effectively with patients who present with a mental illness and a substance abuse problem. Central to this problem is that a universal definition of dual diagnosis or dual disorder does not currently exist. Diminished resources, in the form of financial reimbursement and clinical programs for this complex, diverse population, compound the issue. Finally, as long as clinicians who deal with this population continue to intervene from a dichotomous stance of psychiatry versus chemical dependence, things are not likely to change. This dichotomous clinical approach parallels the federal and state governments' systems that continue to have separate departments for mental health and for alcohol and drug issues. Even more detrimental is that funding sources continue to provide different benefit levels for the two sets of disorders [1].