What works for offenders with co-occurring substance abuse and mental disorders?

FREQUENTLY ASKED QUESTIONS (FAQS) About Drug Abuse Treatment for People Involved with the Criminal Justice System.

Reprinted from "Principles of Drug Abuse Treatment for Criminal Justice Populations" by the National Institute on Drug Abuse (in the Public Domain) by Thomas A. Wilson, MA, LCPC & CEO of Tom Wilson Counseling and Telehealth Center.  

12. What works for offenders with co-occurring substance abuse and mental disorders?

It is important to adequately assess mental disorders and to address them as part of effective drug abuse treatment. Many types of co-occurring mental health problems can be successfully addressed in standard drug abuse treatment programs. However, individuals with serious mental disorders may require an integrated treatment approach designed for treating patients with co-occurring mental and substance use disorders.

Much progress has been made in developing effective medications for treating mental disorders, including a number of antidepressants, antianxiety agents, mood stabilizers, and antipsychotics. These medications may be critical for treatment success with offenders who have co-occurring mental disorders such as depression, anxiety disorders, bipolar disorder, or schizophrenia. Cognitive-behavioral therapy can be effective for treating some mental health problems, particularly when combined with medications.

Contingency management can improve adherence to medications, and intensive case management may be useful for linking severely mentally ill individuals with drug abuse treatment, mental health care, and community services. A specialized type of treatment—Modified Therapeutic Communities (MTCs)—incorporates features of traditional Therapeutic Communities with a special focus on addressing co-occurring mental health conditions.