Understanding Behavioral Health
Behavioral health care is a term used to describe the treatment of mental health and/or substance abuse disorders. Typically, when people speak of behavioral health care, they are referring to care for both mental illnesses and substance abuse/addictive disorders. Managed behavioral health care organizations have emerged to respond to the separation of behavioral health from standard health care.
Mental Illness
Mental illnesses, often referred to as mental disorders, are a significant social problem. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR), mental illness is broadly defined as individuals experiencing symptoms of distress, dysfunction, dyscontrol, disadvantage, disability, inflexibility, irrationality, syndromal pattern resulting in impairment in social, occupational, educational and relational functioning (APA, 2000).
Substance Abuse
The excessive use of a potentially addictive substance, especially one that may modify body functions, such as alcohol and drugs, is known as substance abuse or chemical abuse. Overindulgence in substance use can create a dependence on addictive substances, especially with alcohol or a narcotic drug. Substance or chemical abuse is common and prevalent in society.
Dual Diagnosis
Dual diagnosis is the presence of both mental health disorders and substance abuse disorders (alcohol and/or drug dependence or abuse). In dual diagnosis, an individual is induced either by the illness itself or because of it to substance abuse. This is commonly referred to as “self medicating” because many who develop brain disorders use alcohol, prescription and illegal drugs to ease their mental and emotional pain and as a means of escape. As many as 50 percent of those with mental illness are believed to have substance abuse problems as well. The drug most commonly used is alcohol, followed by marijuana, cocaine, and prescription drugs such as tranquilizers and sleeping medicines.
Those who struggle with dual diagnosis face significant challenges because mental health service agencies are not prepared to deal with patients having both mental illness and substance abuse problems. Often only one of the problems is identified and treated, and even when both are discovered, the individual may bounce back and forth (“ping-ponging”) between services for each or they may be refused treatment for either of them.
While there are significant challenges facing the dually diagnosed, there are signs that the problem is being recognized. An increasing number of programs have been developed to address dual diagnosis. There are some encouraging signs that a better understanding of the problem and improved treatments are on the way. True integrated treatment or “hybrid" programs that address both illnesses together are imperative for positive outcomes. Programs that focus on one or the other can even exacerbate symptoms or cause relapse. Clients with a dual diagnosis have to proceed at their own pace in treatment. An illness model rather than a moralistic one should be used. Attention should also be given to social networks for both patients and their families that can serve as important reinforcers (NAMI, 2008).
