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Barriers to Integrated Treatment

There are a number of barriers that need to be addressed to truly create integrated systems of care for people with co-occurring disorders. Some of these barriers include:

  • Federal, state and local infrastructures that are generally organized to respond to single disorders


  • No single point of responsibility exists for treatment and care coordination 11


  • Mental health and substance abuse service systems often vie for the same limited resources


  • The funding mechanisms for the two systems are often inflexible, difficult to navigate, and involve a myriad of state, federal and private sector payers with variable eligibility requirements and benefit offerings that do not encourage flexible, creative financing 11


  • A lack of any significant connection between mental health and substance abuse provider and service programs12


  • A shortage of training opportunities, creating a situation whereby too few staff are trained in treating both mental and substance abuse disorders12


  • Differing treatment philosophies in the mental health and substance abuse treatment fields12


  • A reluctance by clinicians to address co-occurring disorders, particularly when one of the disorders is in an area in which the clinician is untrained12


  • Co-occurring disorders are prominent among chronically homeless people and other groups that are especially hard-to-serve 11


  • Too little research-based guidance for the treatment of people with less severe co-occurring disorders 12
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