1. Federal and State Initiatives on Dual Disorders Lenore A. Kola, Ph.D. Co-Director, Substance Abuse and Mental Illness Coordinating Center of Excellence http://www.ohiosamiccoe.cwru.edu

2. Federal and State Initiatives Substance Abuse and Mental Health Service Administration (SAMSHA) Priority: As part of a mandate from the Report to Congress, SAMHSA has identified as one of its highest priorities the improvement of treatment and services for individuals with co-occurring mental and substance abuse disorders.

3. Federal Initiatives SAMHSA provides technical, informational, and training resources needed for the dissemination of knowledge and the adoption of evidence-based practices (EBP) in systems and programs that serve persons with co- occurring disorders.

4. Federal Initiatives SAMHSA’s lead agencies for this initiative are: The Co-occurring Center of Excellence (CCOE) The Center for Substance Abuse Treatment (CSAT) The Center for Mental Health Services (CMHS). See website: http:coce.samhsa.gov

5. Federal Initiatives In addition, they developed funding opportunities for seven evidence-based practices including those related to dual disorders and supported employment. Ohio has been funded for two of these projects.

6. Ohio’s Priorities President’s New Freedom Commission on MH recommended transforming the mental health system by taking advantage of the most effective treatments and supports available. The Ohio Department of Mental Health (ODMH) and the Ohio Department of Alcohol and Drug Addiction Services (ODADAS) began a collaboration on projects in the year 1999.

7. Ohio Initiatives ODMH AND ODADAS funded nine programs in Ohio to develop dual disorder programs using the New Hampshire Integrated Dual Disorder Model of treatment. These were competitive grants given to MH and AODA programs that were to develop these “integrated programs.”

8. Development of the Coordinating Centers of Excellence (CCOE) As part of this transformation of ODMH, they developed 10 centers The purpose of the CCOE was to serve as an expert resources providing technical assistance and consultation to improve quality of programs by promoting best practices.

9. The Substance Abuse and Mental Illness Coordinating Center of Excellence (SAMI CCOE ) Ohio SAMI CCOE, initiated in 2001, is a partnership between the Mandel School of Applied Social Sciences and the Department of Psychiatry, CASE School of Medicine, Case Western Reserve University, in collaboration with the Ohio Departments of Mental Health and Alcohol and Drug Addiction Services.

10. The SAMI CCOE - IDDT The main function of the SAMI CCOE is to develop and enhance services to persons with co-occurring mental and substance use disorders by supporting the implementation of the IDDT model. The SAMI CCOE provides: Program and clinical consultation Training and education Research and Evaluation

11. SAMI CCOE Supported Employment ODMH was awarded a SAMHSA grant in October 2003 to disseminate Support Employment through the SAMI CCOE. The Supported Employment CCOE helps organizations implement the Supported Employment model working collaboratively with the Ohio Rehabilitation Commission.

12. Historical Roots of Change Co-occurring problems of substance use and mental health disorders not new – at least not to clients! Programs separated themselves into alcoholism, drugs and mental health.. Then as more and more clients presented with both alcohol and drug problems, programs evolved to deal with them.

13. Need for Change As pointed out in the quadrants, individuals have at minimum 3 combinations of problems seen in our treatment systems. Clients ahead of the service delivery system, and now it is time for providers to deal with people who come with mental health, regardless of severity and who have AODA problems.

14. Research into Dual Disorders Two separate projects that are funded by both federal, state, and foundation dollars to be discussed this morning. Both have the capacity to strengthen practice and service delivery for individuals with co- occurring substance use and mental disorders.

15. Summary We are happy to have the opportunity to talk to practitioners this morning to translate our scientific findings into information that we hope will be useful in your work.