Program Structure

This includes organizational aspects of a program such as mission, license or certifications, and financing (e.g., does the mission statement include a clear expectation of treating both mental health and substance use challenges?  Can the program bill for treating both?).

Program Milieu

This refers to the physical and social environment of an organization (e.g., does the program clearly welcome people with both mental health and substance use challenges? Is there literature describing both conditions and the interaction between them?).

Clinical Process: Assessment

This is related to screening and assessment (e.g., Is the program routinely providing screening and integrated assessment for both mental health symptoms and substance use? Are diagnoses made for both and included in documentation?  Does the program regularly assess a person’s stage of change for both mental health symptoms and substance use?).

Clinical Process: Treatment

This is related to treatment planning and interventions offered (e.g., Is there an integrated treatment plan that includes both mental health and substance use challenges?  Is stage-wise treatment offered for both? Are peer supports available?  Are family interventions offered?  Does psychoeducation include information about mental health symptoms, substance use, and the interactions between them?).

Continuity of Care

This refers to treatment coordination, ongoing management, and follow-up (e.g., is there a focus on ongoing recovery for both mental health and substance use challenges? Are co-occurring disorders addressed in discharge planning?).

Staffing

This includes staff expertise available to treat both mental health symptoms and substance use. (e.g., is there a prescribing clinician available to offer medications for both mental health symptoms and substance use? Do clinical staff have experience treating both? Do care reviews include supervision for both mental health symptoms and substance use? Are peers in dual recovery available?).

Training

This refers to whether staff have basic and specialized training (e.g., do staff have basic training in prevalence, common signs and symptoms, and detection of co-occurring disorders?  Do clinical staff have advanced specialized training in integrated psychosocial or pharmacological treatment?).

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