The course, treatment, and outcome of substance disorder in persons with severe mental illness

Individuals with co-occurring substance abuse and severe mental illness are particularly vulnerable to negative outcomes. This paper reviews findings on the longitudinal course of dual disorders in traditional treatment systems, which provide separate mental health and substance-abuse programs, describes the movement toward programs that integrate both types of treatment at the clinical level; reviews evidence related to outcomes in integrated treatment programs, and discusses health-care policy changes that would encourage effective treatments.