Co-Occurring Mental Health & Addiction Disorders
Mid-Valley Behavioral Network has from its inception been an integrated network with mental health and chemical dependency provider agencies working together as equal partners. Our commitment to providing integrated treatment for individuals with co-occurring disorders (COD) is pursued by the Mental Health/Chemical Dependency Integration Group, which has been active since 1998.
In 2000 we selected the Comprehensive, Continuous, Integrated Systems of Care (CCISC) model for systems change, and contracted with Ken Minkoff, M.D. to provide training and consultation. We adopted the CCISC assumption that among Oregon Health Plan members, the presence of these co-occurring disorders is the rule rather than the exception. Our strategy is to ensure a welcoming attitude and staff competency to screen for and respond to both disorders within every MVBCN agency. In addition, many staff and programs are able to provide fully integrated care.
In 2001 each agency completed a self-assessment, and began implementing changes in system, program, clinical practice and clinician competencies. After attempted a number of approaches to formally assess our system’s progress, the instrument we found most useful was the CCISC Outcome Fidelity and Implementation Tool (CO-FIT). In addition to providing an overview of the regional system, this tool allowed us to produce an agency-specific profile of COD competency on multiple dimensions.
To maintain this level of integrated practice we include COD goals in our annual Quality Improvement Plan. We have a series of recurring staff trainings which are available to help clinicians new to our Network in understanding and acquiring skills for our integration model. Each year we ask agencies to audit a sample of COD charts using an adaptation of 4 questions from the Dual Disorders Fidelity Scale. Supervisors find this tool very helpful in working with individual staff on expectations for assessment, treatment planning, and use of motivational strategies. Our annual consumer survey solicits consumer perception of dual disorders and their report of whether both issues are addressed in treatment. Data is used to identify staff training and agency consultation needs.