Substance use and mental health disorders: Psychologists’ role in bridging the gap.

Abstract

Nearly 30% of people with a mental health disorder will also have a substance use disorder at some point in their lives. Despite widespread evidence of the complex interactions between mental health and substance use and the value of integrated treatment, the majority of people with concurrent disorders do not receive treatment that addresses both conditions. Psychologists are ideally suited to bridge this gap in care, but this will not be without challenges. Psychologists possess extensive skills in identifying, diagnosing, and treating mental health disorders, which are transferrable to substance use disorders. Psychologists also have formal training in supervision and consultation and thus can supervise or act as consultants for other professionals in treating concurrent disorders. They have expertise in program development, evaluation, and research and can lead projects to integrate mental health and substance use services. Barriers to psychologists bridging this gap center on siloes in our healthcare system, the lack of training for psychologists to develop competency and confidence in substance use disorder diagnosis and treatment, misperceptions about how individuals with substance use disorders respond to psychological treatment, as well as system barriers. Overcoming these barriers comes with clear benefits and will require changes to professional training, clinical practice, and research on evidence-based treatments for concurrent disorders. Agencies across Canada are calling for action to ensure individuals with concurrent disorders receive the integrated services they require. Being at the leading edge of this change offers an important opportunity for psychologists. Public Significance StatementResearch demonstrates that integrated treatments that address both mental health and substance use problems simultaneously, result in improved clinical outcomes. Yet, the majority of individuals with cooccurring mental health and substance use difficulties do not receive integrated treatments. Herein, we propose that psychologists are ideally suited to bridge this gap in care and outline the barriers and solutions for psychologist to improve care for individuals with concurrent disorders.

Evaluating the substance use disorder treatment gap in the United States, 2016−2019: A population health observational study

“…Mental health providers may be helpful with improving motivation to seek help and reduce the stigma surrounding treatment in general. In all, little is known about the SUD screening and referral practices of non‐SUD mental health providers, aside from periodic psychologist calls for greater training and education in SUD treatment services 25,26 . More research is needed to understand the role of general mental health providers in helping patients access SUD treatment and the help‐seeking differences between SUD and general mental health treatment patients.…”

Integrated treatment for comorbid eating disorders and substance use disorders: a scoping review protocol

“…13 Considered the foundation of best practices for concurrent substance use disorders and mental illness, there have been repeated and widespread calls for integrated treatment to specifically address comorbid EDs and SUDs. [10][11][12]14,15 Clinical practice guidelines are sets of suggested treatment measures based in evidence synthesized through systematic reviews and through the evaluation of other treatment options. 16 Several resources have provided recommendations to guide the treatment of comorbid EDs and SUDs.…”

“…In contrast to parallel treatment (ie, simultaneous treatment for 2 disorders, delivered independently by separate treatment teams) and sequential treatment (ie, treating the most debilitating disorder first, and subsequently treating other disorders), integrated treatment is delivered by a unified clinical team, involves screening and treatment planning for both disorders in a coordinated manner, and comprehensively addresses common areas of concern seen with concurrent disorders 13 . Considered the foundation of best practices for concurrent substance use disorders and mental illness, there have been repeated and widespread calls for integrated treatment to specifically address comorbid EDs and SUDs 10–12,14,15 …”