Final Report & Recommendations of the Statewide Task Force on Dual Diagnosis

The Dual Diagnosis Report from The Statewide Task Force with Recommendations for The Next Big Step.

Co-Occurrence can also be defined as dual diagnosis. This means people have a mental illness as well as substance abuse such as alcohol and drugs. It is a fast-growing problem in our society, and it includes all segments of society especially homeless and underserved residents. According to a Tennessee mental health Institute report, the participants in the study were diagnosed with some mental illness but 62% diagnosed with dual diagnosis. The experts agree on dual diagnosis and substance disorders are not rare; there are no more exceptions but expectations. And this is the core truth of society. It involves one or more psychiatric disorders combined with substance use disorders.

From Nov 1998 to Jan 2000, the Task Force on Co-occurring Disorders worked with the Dual Diagnosis, sponsored by the large population, civil society, and the Tennessee government institutions. Seven regional task forces were formed with 123 members. The working party met for 16-17 hrs in order to pinpoint our most serious concerns about substance use disorders and co-occurring psychiatric issues. A dual diagnosis recovery network was initiated statewide for the universal availability of treatment options.

Eventually, the working party reached an agreement on whole state recommendations addressing our current requirements. The recommendations followed a “no wrong door” approach that focused on affordable solutions while taking into account poor economic conditions. In a wrong door system, the patient is given treatment only in one discipline, in the door patient has entered, and a comprehensive approach for the treatment of dual diagnosis is ignored. Many other systems still resemble the wrong door model, but there is a need for gradual improvement and up-gradation of such facilities. The Executive Committee Planning Council agreed to approve the concluded report, “Co-occurrence: Bridging the Gap for Change; the Next Step,” which was then handed over to the Developmental Disabilities Commissioner and Tennessee Departments of Mental Health and Health.

Members of the working party have held meetings to discuss whether recommendations can progress to practice or policy. The Commissioners asked that two surveys be developed in order to prioritize the recommendations. The first, “Priority Survey,” contains 14 sections and suggested changes and 52 improvements as they appear in the result, with a form at the end of the article that readers may use in order to rate recommendations and pass them to us for analysis in dual diagnosis management.

Answering advice for the population-oriented survey, the four-leaves “Prioritization Survey Revised” to spread-sheet formed to enable parties to rate conclusions having coded terms. Participants should be aware that full recommendations in “Priority Survey Revised” are found only in “Priority Survey.”The last date of submission was June 27, 2000.

Both survey documents provide contact information. It would be helpful if Tennessee citizens responded to this notice to make us establish the hopes of stakeholders and taxpayers and large hopes for this reason. The task force is not likely to succeed if it does not promote its work. The report will remain in a dusty corner on your bookshelf. Local Recovery Committee and Co-occurring or Dual Diagnosis have been focused so to continue responsibility that the task force began, starting more working group members continuing within leading duties. These committees' will ensure the quality and adequacy of services provided to persons with co-occurring disorders in their community, stress successfully for the use of working party recommendations for dual diagnosis, and establish long-term plans that may require support from the federal government and other public health providers.

Some Additional Recommendations Were Made by the Task Force:

  • Educational and awareness activities need to be increased; the University curriculum has to be modified and upgraded to enable the professional staff to effectively treat the people with Co-Occurrence; public awareness programs and public education to remove the stigma associated with the treatment of dual diagnosis. Education decision-makers should be prompted to increase activities to promote mental and physical health and discourage addictions.
  • Recommendations such as facilitation centers in departments of Mental Health, mental disabilities, better of alcohol and drug abuse services; And policies to further enhance services delivery to the people with comorbidities and dual diagnosis and strengthening of the criminal justice system to work against the culprits spreading drug abuse adding further to the mental health problems.
  • A continuum Ok has to be developed consistent with existing techniques to effectively e care of the individuals with dual diagnosis and to arrange statewide workshops to enhance the training of the mental health professionals and alcohol and drug treatment staff.
  • Oversight authority needs to be established for the best practice of standard statewide. Authority must be powerful and accountable for the effective practices and development of a monitoring system to deliver services.
  • A feedback system based on research and evaluation needs to be established to ensure that people with dual diagnosis are properly identified and treated.

Departmental collaboration is needed to evaluate the contracts of providers and other entities. Health Care professionals and veterans of dual diagnosis should be given representation in policy and advocacy of this issue. And there is a need to establish command and control centers or coordinated communication centers between states and the Federal government to come up with combined efforts and resources to cost-effectively face the issues of dual diagnosis. There is a need to review the existing laws and practices to evaluate loopholes of the system which have been allowing substance abuse in society. Where there is the need to establish a diverse committee reviewing all the aspects, it must be in charge of reviewing the policy of immediate discharge entry in the statement of insurance benefits. So we can assess the treatment given for dual diagnosis immediately upon release.

In the fiscal year 1991, a Centre for substance abuse prevention was granted funds to establish prevention services for children of newly diagnosed parents. The project was about educating and supporting the children and families of victims of dual diagnosis. Efforts are increasing on the national level to develop plans to cope with the social dilemma and come up with the solution for Co-Occurrence. This will reduce both the social and individual cost of the Co-Occurrence. Two associations have collaborated on the federal level representing statements to health and substance abuse directors, creating a working party that has drafted a way to finance and deliver services to the people with dual diagnosis.

There is also a need for mending the stigmata of society towards this problem. Many strange stigmas were identified in the hospital settings designed for treating people with dual diagnosis, many of which were designed To Treat people with serious Co-Occurrence disorders. For many years, the Statewide Task Force has conducted meetings and task force meetings at the Governor's Office, reviewing their recommendations and suggesting ways in which the State can better address the opioid crisis. The meetings are open to the public, but members must be registered members to attend. All meetings are designed to promote dialogue and open communication between the various agencies and departments. Last month's meeting brought several new ideas to the table and addressed some current issues related to dual diagnosis. Although not all recommendations were passed, the Governor and his staff are encouraged by the results of the meetings, which they say have proven that the overdose deaths and substance abuse that plague the State is becoming an overwhelmingly dangerous situation. This revealed that separate and distinguished training programs in schools and educational settings are not helpful in providing a universal standardized cross-training curriculum for addressing the condition. There is a need to expand and instill knowledge in this staff about Dual diagnosis. There are many key deficiencies in our educational system that can only be addressed by focusing on the education of professionals.

This cannot be achieved without efforts to develop essentially skilled health professionals equipped with the tools of counselling social medicine welfare work and enhanced exposure with people of dual diagnosis. These are some fundamental barriers in the treatment of Co-Occurrence. There is a need for the mass drive of awareness about Co-Occurrence in the general public, As well as training at the university level about fundamental skills of handling dual diagnosis.

This pilot project will comprehensively study and give effective treatment strategies to deal with Co-Occurrence. This pilot project has expanded to a further 16 programs that are nationally recognized and are examples for other states to be followed. Texas has been successful in establishing communication between departments to meet the needs of patients affected by other dual diagnosis disorders.

Another exemplary initiative is by Oregon; they have developed a task force to enhance the services between mental health and office of alcohol and drug abuse programs. This task force was created in 1999 and submitted its final report in 2000. This was a joint work of departmental staff administrators, families, universities, Academics, and other portions of the society to build a comprehensive approach and view of the needs of the issue. And to come up with the comprehensive plan to deal with dual diagnosis.

New York is most affected by drugs, so the office of alcoholism and substance abuse collaborated with mental health to address the number of individuals with dual diagnosis and addiction disorders in both systems. An MOU was signed between the two authorities, food joint screening and development of a training program with the required curriculum and inter-system collaboration as this can be most effective in service.


Final Report & Recommendations of the Statewide Task Force on Dual Diagnosis.

Priority Survey
Prioritization Survey Revised

MS Word Document – 1,302 kb
MS Word Document – 96 kb
Due July 26, 2002

MS Word Document – 43 kb
Due July 26, 2002
Same file in zip format – 876 kb

Among supporting factors of the task force formation was the state Dual Diagnosis and Recovery Committee, which was supposed to have people from local committees to work on common objectives as these regional committees form a whole state view dual diagnosis.