Effects of integrated and comprehensive treatment to persons with mental disorders and substance use disorders.

Patients with co-occurring substance abuse and mental disorders are characterized by high suicide and treatment drop-out rates, and long-lasting interpersonal, work, school, health and legal problems. And because mental disorders and substance misuse inte ract and co-excists, it is important to provide treatment that integrates their substance misuse and mental health problems in a comprehensive way. The over-all aim of this multi-centre study is to evaluate the effects of disseminating and training clinic ians in evidence-based integrated and comprehensive treatment, to persons with mental disorders and co-occurring substance abuse. The effects of the dissemination will be assessed on changes in the clinicians work and treatment methods, and on twelve mont hs patient out-come. The effects of implementing evidence-based treatment (N=75) are compared with standard treatment or treatment-as-usual (N=75). The effects on substance misuse, psychiatric symptoms, psychosocial functioning, treatment drop-out rates, user satisfaction and quality of life, are assessed at study entry and after twelve months of treatment. The patients included in the study are all consecutive referrals to Community Mental Health Centres (DPS) in the Eastern Norwegian Regional Health Aut hority with any substance use disorder and any co-occurring mental disorder. The study is a collaborative project between the Eastern Norway Health Authority, the University of Oslo, the Eastern Norwegian Centre of Competence on Substance Misuse and Gambl ing, and SINTEF Health Research.