In looking at the 2009 admissions data to GCASA, it appears that about 43% of 947 patients admitted to GCASA's outpatient treatment programs have a history of mental health treatment. About 65% of the 103 patients admitted to the Atwater Community Residence and Supportive Living have a history of mental health treatment.
Implications for GCASA's services:
1. It is apparent that GCASA's patients present with complex problems and that good treatment needs to be comprehensive and address the patient's psychiatric as well as substance abuse problems.
2. In thinking about patients with co-occurring disorders it is often not clear whether the substance abuse problem has triggered the psychiatric problem or the psychiatric problem has triggered the substance abuse problem. Whichever, it takes a skilled and experienced clinician to understand how the psychiatric and substance abuse problems are inter-related.
3. GCASA collaborates with mental health providers and these cases which involve both disorders take more case management and coordination services and therefore are more expensive to treat. Unfortunately, reimbursement mechanisms don't differentiate the costs involved in treating people with co-occurring disorders as compared to people with a substance abuse disorder alone.
4. From a management perspective, it requires more resources to treat people with co-occurring disorders because it requires a more highly trained and therefore more expensive staff. Also, the time that clinicians spend on cases which involve co-occurring disorders is increased.
5. Patients admitted to residential services have a longer history of substance abuse treatment and their problems are more severe. It makes sense that the percentage of patients admitted to residential services would be higher. GCASA is very blessed to have Mary Beth Pace, L.C.S.W., a MICA (Mentally ill chemical abuser) specialist as the new Assistant Director of Residential Services. Having a mental health professional in a leadership position in residential services is a big asset for GCASA's service delivery.