Thursday, March 4, 2010

GCASA treats high percentages of patients with substance abuse and psychiatric disorder

There is a lot of talk in high places these days in the Substance Abuse and the Mental Health fields about what is named "co-occurring disorders" or here in New York State, Mentally Ill Chemical Abuser, or MICA.

Many people struggling with substance abuse disorders also have psychiatric disorders, 44% or 458 out of 1050 patients report having had some mental health treatment in their life at GCASA.

Here is the program specific data:

In Genesee county it was 263/606 for a percentage of 43.4.
In Orleans county it was 127/341 for a percentage of 37.2
In the Atwater Community Residence it was 37/57 for a percentage of 64.9.
In Supportive living it was 31/46 for a percentage of 67.4%.

People with a combination of psychiatric and substance abuse disorders are more difficult to treat and require a more skilled labor force. Many substance abuse counselors are not all that well trained in psychiatry, and many mental health professionals are not well trained in substance abuse. These professional groups like to fight with each other and the patient often looses. Many patients are told by mental health professionals that their psychiatric disorder cannot be effectively treated until their substance abuse disorder is treated and many substance abuse professionals tell patients that their substance abuse disorder cannot be treated until their psychiatric problems are dealt with.

It is rare to find behavioral health professionals who feel competent to treat both substance abuse and mental health disorders. At GCASA we are fortunate to have such trained staff and we offer MICA services in both of GCASA's clinics and in our residential services program.

GCASA's medical director, Dr. Charles King, a Family Medicine Physician with accreditation in addiction medicine often provides front line psychopharmacological treatment for GCASA's patients. Unfortunately, there often is a long wait of a couple of months for GCASA's patients to access mental health treatment in the two county mental health clinics in Genesee and Orleans counties.

Patients with substance abuse and psychiatric disorders are likely to be more dysfunctional with longer pre-morbid disordered histories which makes the prognosis for treatment more questionable. The amount of services such patients need are much greater than someone with just a substance abuse disorder and so they are more costly to treatment.

For the most part, GCASA treats these patients effectively with meager resources. However, treating these patients with meager resources stresses the system.

This is article #8 in a series on 2009 GCASA admission data.

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