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1 http://www.ncbi.nlm.nih.gov/books/bv.fcgi? rid=hstat5.chapter.74073

2 Syllabus Quiz What are the different sources of reading assignments? What is plagiarism? What is an “article response” paper and when are they due? Where can you find the citations for the Reading List? By what date should you read Appendix F and look at www.mattc.org?www.mattc.org How is professionalism defined? Questions?

3 Co-Occurring Disorders The evolution, prevalence and ways of understanding them

4 What are co-occurring disorders? Two or more mental disorders, at least one of which is a Substance Related Disorder. Previous terms used: –Dual Diagnosis –Dual Disorders –Mentally Ill Chemical Abuser –Chemically Addicted Mentally Ill –Double Trouble –Etc. see page 27 in TIP 42

5 Important terms Mental disorders Serious and persistent mental illness Mental health issues Substance Use Disorders or “SUDs” –Abuse –Dependence Substance Induced Disorders Chemical Dependency Addiction

6 Prevalence of COD Source: TIP 42 and “Epidemiology of Co-Occurring Substance Use and Mental Disorders,” SAMHSA Substance abuse/dependence: general population8.2% or 9+% Substance abuse/dependence: serious mental illness23.2% Serious mental illness: general population7% Serious mental illness: substance abuse/dependence20.4% Co-Occurring Disorders4-7 million Substance abuse/dependence: people with schizophrenia47% Substance abuse/dependence: people with bipolar d/o56% Substance abuse/dependence: people with major depression27% Substance abuse/dependence: people with panic d/o35.8%

7 Scope of Practice-CDP Areas of Focus 1.Recognition of signs and sx of mental health issues and/or crisis. 2.Understand relationship between cd and mh. 3.Communicate with other treatment providers: coordinate tx plan, advocate. 4.Help cx develop coping strategies. 5.Educate cx.

8 Similarities and Differences Between the MH and CD Fields 1.Differences Varied goals Role of medication Role of spirituality Labeling Role of professional Idea of powerlessness

9 2.Similarities Biopsychosocial model Ongoing treatment Family involvement Mutual support/self help Continuum of care

10 Explaining the relationship between m.h. and sud 1.Secondary substance abuse 2.Secondary psychiatric disorder 3.Common factor 4.Bidirectional

11 Quadrants of care-pg. 29 Category I:Less severe MD, Less severe SUD. Primary healthcare setting Category II:More severe MD, Less severe SUD. Mental Health system Category III:Less severe MD/More severe SUD. Chemical dependency system Category IV:More severe MD/More severe SUD. Psych. hospitals, jails, ER, etc.

12 Small Group-Reading Review 1.Form groups of 4-5. 2.Have a go-round-each person identify one important piece of information from ch. 3. 3.Discuss each of these to clarify meaning and why it is important. 4.Summarize the “guiding principle” you are assigned. 5.Do you have questions re: reading?


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