1. Recovery Strategies for Combined Mental Illness & Substance Use Disorders Consumer Education and Support Statewide Call-In: April 24, 2008

2. Welcome! Thank you to all who have joined in for today’s call! Instructions for CEU’s for today’s call – Fax Sign-In Sheets to: – Josephine Brodbeck, FAX (309) 693-5101 – Include information on where to send the certificates Schedule for future calls – May 29 th – Crisis Plans: Making Choices for Difficult Times – June 26 th - How to Develop Inclusive Agency-Based Advisory Councils

3. Objectives for Today’s 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

4. Guidelines for Today’s Call All Speakers Will Use Person-First Language All Acronyms Will Be Spelled Out and Defined Diverse Experiences Will Be Heard and Validated

5. Personal Testimonials of Recovery: Jerry, 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?

6. 6 6 How common are substance use disorders in people with mental illnesses?

7. 7 7 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

8. 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)

9. Why do people with co-occurring disorders stop using substances ? To change one’s 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)

10. 10 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

11. 11 Positive Life Factors That Promote Recovery A regular, enjoyable activity that provides structure to one’s day and provides a sober social network Decent safe and stable housing A loving, caring relationship with someone sober, who accepts the person’s mental illness A positive therapeutic relationship, including regular contacts, with a mental health professional Alverson et al., CMHJ (2000)

12. 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 )

13. 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.

14. 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)

15. 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)

16. 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)

17. 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 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 www.professored.com – Click on “Publications,” then click on “Double Focus Mutual Support”

18. 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/communitysupp ort/toolkits/cooccurring/ Information on IDDT for Consumers from SAMHSA: http://mentalhealth.samhsa.gov/cmhs/communitysupp ort/toolkits/cooccurring/consumers.asp

19. 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

20. Thank You! Written Questions Can Be Sent To: – Tim Devitt, Director of Integrated Dual Disorders Treatment, Thresholds, Inc. – tdevitt@thresholds.orgtdevitt@thresholds.org – FAX: ( 773) 572-5290 – Nanette Larson, Director of Recovery Support Services, DHS/Division of Mental Health – Nanette.Larson@illinois.gov Nanette.Larson@illinois.gov – FAX: (309) 693-5101