Treatment of Mental Illness and Comorbid Substance Abuse: Concepts for Evidence-Based Practice

Dually diagnosed clients are proven to be among the most difficult and costly to treat, and have a high rate of relapse. Evidence-based models have been identified that may improve outcomes, but research indicates the models face barriers to implementation. The author provides a historical perspective of care to the dually diagnosed client, a view of a proposed evidence-based model, and strategies that research indicates may help overcome the barriers of implementing evidence-based care. The Advanced Practice Nurse (APN) is poised to coordinate the process of implementing evidence-based practices, which includes consideration of multicultural, ethical, political, and socioeconomic factors. Research is indicated to determine strategies to finance, contract for, reorganize, and train in relation to dual diagnosis services.