Objective: To investigate the prevalence and trends of Integrated Dual Diagnosis Treatment (IDDT) implementation—an evidence-based model for co-occurring mental health and substance use disorders—within U.S. mental health facilities between 2010 and 2018.
Methods: This study analyzed longitudinal data from a national survey of mental health treatment facilities offering substance use services to assess changes in IDDT utilization over time. The research further examined state and facility-level factors associated with the provision of integrated dual diagnosis services in 2018.
Results: A significant increase was observed in the proportion of mental health facilities providing any substance use services, rising from 50.1% in 2010 to 57.1% in 2018. Paradoxically, among these facilities, a smaller percentage reported offering Integrated Dual Diagnosis Treatment in 2018 (74.8%) compared to 2010 (79.6%). While IDDT prevalence showed some increase in recent years, aligning with the expansion of substance use services, this growth has not kept pace with the overall increase in service co-location. Mental health facilities integrating substance use services were also more likely to offer a broader range of mental health services and access multiple funding streams. Facilities with substance use disorder services providing IDDT were more frequently licensed by State Substance Agencies and more often incorporated psychotropic medication management and group therapy into their services. Furthermore, facilities situated in states with policies supporting the Integrated Dual Diagnosis Treatment model demonstrated a higher likelihood of offering this approach.
Conclusions: The expansion of substance use treatment services within mental health facilities has not been accompanied by a corresponding integration of dual diagnosis treatment models. This disparity underscores a critical need for intensified efforts to comprehensively address the complex and intertwined needs of individuals with co-occurring disorders seeking treatment at Dual Diagnosis Treatment Facilities. The findings highlight the urgency for mental health service providers and policymakers to prioritize the implementation of truly integrated care models to effectively serve this vulnerable population.
