Best Practices - Concurrent Mental Health and Substance Use Disorders

Implications for Research

The following are the research recommendations:

• there is wide variation in the level and content of integrated treatment at the program level. More research is needed on the effectiveness and cost-effectiveness of various interventions for many of the sub-groups within the concurrent disorders population, as well as fidelity measures to assess the nature and level of integration;
• there is wide variation in the level and content of integrated treatment at the system level. More research is needed on the impact of these system-level interventions on access to treatment and support; engagement and retention in the system and the effectiveness and cost-effectiveness of various interventions for each of the sub-groups within the concurrent disorders population. Research should also investigate the value of fidelity measures to assess the nature and level of system integration; and urban/rural differences;
• two clusters of concurrent disorders were omitted from these of best practice guidelines due to a lack of research evidence – concurrent substance use and sexual disorders; and concurrent substance use, mental health disorders and pathological gambling. More research is needed in these areas;
• more research is needed on treatment/support for specific combinations of psychoactive substance use disorders (e.g., cocaine) and specific mental health disorders (e.g., depression);
• more research is needed on the link between substance use disorder and anger disorders that are independent of antisocial personality disorder;
• more research is needed on the link among dysfunctional parenting, child abuse and co-occurring mental health and substance use disorders;
• brief, validated measures are needed that would screen for mental health disorders among people seeking treatment for substance use disorders.