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In any given year, one in five people in Canada experiences a mental health problem or illness, with a cost to the economy of well in excess of $50 billion. In a 2001 study, researchers calculated that about three percent of violent offences could be attributed to mental illness and another seven percent to substance use problems; theoretically, only one in 10 crimes could be prevented if these disorders did not exist.
-Arboleda-Flórez & Stuart (2001)
The Problem
There is a need for the integration of Canada’s healthcare system which typically treats addictions and mental illnesses independently. This can make it challenging for people with concurrent disorders to receive appropriate services and treatments. In many cases, these people enter the healthcare system through the ‘wrong door’, resulting in system ineffectiveness and poorer outcomes. Although the overall treatment and case plan should consider both mental health and substance use problems, it is sometimes best to treat one problem first. For example, most people who have concurrent mood and alcohol disorders are likely to recover better if the alcohol disorder is treated first. Multiple sources of stigma increase the risk of mental, emotional and physical health problems. The more visible a person's differences, for example, physical disability, noticeable developmental delay, non-Caucasian skin colour, unconventional dress, low English-language ability and accents, the less comfortable they are about accessing mental health care.
During the mid-1980s, a number of initiatives began to combine mental health and substance abuse services in an attempt to meet this need. These programs worked to shift the method of treatment for substance abuse from a confrontational approach to a supportive one. They also introduced new methods to motivate clients and worked with them to develop long-term goals for their care. Although the studies conducted by these initiatives...