dave neilsendave neilsenDeputy DirectorDeputy Director

Commitment, Knowledge and Services…Commitment, Knowledge and Services…

The Department of Alcohol and The Department of Alcohol and Drug Programs (ADP) is committed Drug Programs (ADP) is committed to providing excellent quality care to providing excellent quality care and services to our clients with Co-and services to our clients with Co-Occurring Disorders (COD).Occurring Disorders (COD).

As a former provider, Director Zito As a former provider, Director Zito knows it is critical that providers knows it is critical that providers are able to serve our clients that are able to serve our clients that walk through the treatment door. walk through the treatment door.

State of AffairsState of Affairs: ADP, the Department of Mental : ADP, the Department of Mental Health and theHealth and the Co-Occurring Joint Action Council’s Co-Occurring Joint Action Council’s (COJAC) Collaboration has lead to progress in COD (COJAC) Collaboration has lead to progress in COD treatmenttreatment

COJAC COJAC Screening Sub-Committee developed Screening Sub-Committee developed a simple instrument designed to assist a simple instrument designed to assist substance abuse and mental health providers substance abuse and mental health providers screen for clients in need of further screen for clients in need of further assessment of COD. assessment of COD.

– The instrument containsThe instrument contains nine questions nine questions– Requires very little time to administerRequires very little time to administer– Minimal staff training and can be used in a wide Minimal staff training and can be used in a wide

variety of settingsvariety of settings

Validation of COJAC Validation of COJAC ScreenerScreener

ADP is sponsoring and conducting a scientific study ADP is sponsoring and conducting a scientific study designed to establish the validity of the COJAC designed to establish the validity of the COJAC screening instrument. screening instrument.

The duration of the study is two years. The duration of the study is two years.

Once validated, one possible next step is:Once validated, one possible next step is:

Adoption of this instrument throughout Adoption of this instrument throughout California. California.

The use of this instrument will ensure that those with The use of this instrument will ensure that those with COD are identified and served at every point of entry COD are identified and served at every point of entry because there should be “no wrong door.”because there should be “no wrong door.”

Use of the Dual Diagnosis Capability Use of the Dual Diagnosis Capability Assessment Tool (DDCAT) to Assess Assessment Tool (DDCAT) to Assess Treatment Providers COD Services Treatment Providers COD Services in the following Areas:in the following Areas:

I. I. Program’s Environment Program’s Environment

II. II. Clinical Process: Assessment Clinical Process: Assessment

III. Clinical Process: TreatmentIII. Clinical Process: Treatment

IV. Continuity of CareIV. Continuity of Care

V. V. Program Structure Program Structure

VI. StaffingVI. Staffing

VII. TrainingVII. Training

Benefits of the DDCATBenefits of the DDCAT

User friendlyUser friendly ConcreteConcrete Identifies strengths in programsIdentifies strengths in programs Identifies specific avenues for Identifies specific avenues for

changechange Develops a baseline for Develops a baseline for

development of action plans to development of action plans to advance dual diagnosis capability advance dual diagnosis capability

Endorsed by the Substance Abuse Endorsed by the Substance Abuse and Mental Health Services and Mental Health Services Administration (SAMHSA)Administration (SAMHSA)

SAMHSA provides state incentive grants to SAMHSA provides state incentive grants to states using the DDCATstates using the DDCAT

SAMHSA views the DDCAT as an instrument that SAMHSA views the DDCAT as an instrument that fosters integrated services for persons with co-fosters integrated services for persons with co-occurring mental and addictive disordersoccurring mental and addictive disorders

SAMHSA endorses the DDCAT as an assessment SAMHSA endorses the DDCAT as an assessment tool that may be used to determine tool that may be used to determine effectiveness of programs providing integrated effectiveness of programs providing integrated treatment servicestreatment services

Currently, 20 other states are using this Currently, 20 other states are using this instrument in similar effortsinstrument in similar efforts

ADP’s Pilot of the ADP’s Pilot of the DDCATDDCAT

ADP’s Pilot involves administering and ADP’s Pilot involves administering and validating the scores of the DDCAT validating the scores of the DDCAT instrument among 3 southern and instrument among 3 southern and 3 northern California providers. 3 northern California providers.

This effort will help the state and This effort will help the state and substance abuse providers determine substance abuse providers determine their capability for treating COD:their capability for treating COD:– A first step in identifying which providers are A first step in identifying which providers are

delivering effective treatment and what program delivering effective treatment and what program areas can be improved upon areas can be improved upon

– Helps inform the field to move towards standards Helps inform the field to move towards standards in care for COD programsin care for COD programs

Opportunities within the Mental Health Opportunities within the Mental Health Services Act (MHSA)Services Act (MHSA)

The MHSA, Prevention and Early The MHSA, Prevention and Early Intervention (PEI) component, provides a Intervention (PEI) component, provides a unique opportunity to accomplish some of unique opportunity to accomplish some of this work. this work.

The PEI allows substance abuse providers The PEI allows substance abuse providers to participate locally by offering programs to participate locally by offering programs for individuals who are at risk of for individuals who are at risk of developing a serious mental illness or for developing a serious mental illness or for those whose substance abuse treatment those whose substance abuse treatment would prevent the worsening of a mental would prevent the worsening of a mental illness. illness.

DDCAT ON THE WEBDDCAT ON THE WEB

The DDCAT (14 pages) is available for download at the following The DDCAT (14 pages) is available for download at the following location:location:

http://www.smilevermont.com/mh/visi/documents/DDCAT_fidelity_scale.pdfhttp://www.smilevermont.com/mh/visi/documents/DDCAT_fidelity_scale.pdf

An introductory manual (40 pages):An introductory manual (40 pages):http://www.smilevermont.com/mh/visi/documents/DDCAT_introductory_manual.pdfhttp://www.smilevermont.com/mh/visi/documents/DDCAT_introductory_manual.pdf

An explanatory computer slide show (67 pages):An explanatory computer slide show (67 pages):http://coce.samhsa.gov/cod_resources/PDF/DDCATIntroVersion23.pdf http://coce.samhsa.gov/cod_resources/PDF/DDCATIntroVersion23.pdf

A Dual Diagnosis Capability in Addiction Treatment Toolkit (127 A Dual Diagnosis Capability in Addiction Treatment Toolkit (127 pages):pages):

http://www.smilevermont.com/mh/visi/documents/DDCAT_Toolkit.pdfhttp://www.smilevermont.com/mh/visi/documents/DDCAT_Toolkit.pdf

PEI StrategiesPEI Strategies

ADP’s COD Unit staff developed and ADP’s COD Unit staff developed and disseminated several strategies to disseminated several strategies to substance abuse providers.substance abuse providers.

Providers can use in collaboration Providers can use in collaboration

with their counties, for the provision with their counties, for the provision of services, when consistent with of services, when consistent with local PEI priority activities.local PEI priority activities.

Strategies for Substance Abuse Strategies for Substance Abuse in:in:

Student Assistance ProgramsStudent Assistance Programs Youth DevelopmentYouth Development Mentoring ProgramsMentoring Programs Drug Court and Proposition 36 Support Drug Court and Proposition 36 Support

ProgramsPrograms Hiring of Mental Health Staff at Alcohol Hiring of Mental Health Staff at Alcohol

and Other Drug Treatment Programsand Other Drug Treatment Programs – – “No Wrong Door” “No Wrong Door”

Family Counseling for Domestic Family Counseling for Domestic Violence Clients and Family MembersViolence Clients and Family Members

Suicide PreventionSuicide Prevention

For More InformationFor More Information

The Co-Occurring Joint Action CouncilThe Co-Occurring Joint Action Council

www.adp.ca.gov/cojac/index.shtmlwww.adp.ca.gov/cojac/index.shtml

The Department of Alcohol and Drug The Department of Alcohol and Drug ProgramsPrograms

www.adp.ca.gov/COD/index.shtmlwww.adp.ca.gov/COD/index.shtml

The Co-Occurring Disorders UnitThe Co-Occurring Disorders Unit

CODUnit@adp.ca.govCODUnit@adp.ca.gov