Rehabilitation for Adults with Co-Morbid Substance Use and Mental Health Disorders: A Scoping Review of Programmatic Outcomes and Evidence Gaps
Abstract:
Background: Adults with co-morbid substance use and mental health disorders represent a complex population requiring specialized rehabilitation approaches. The outcomes of different treatment models for this population requires careful evaluation.
Aim: To identify and critically appraise key program components, implementation barriers, and knowledge gaps in current rehabilitation interventions, informing future research, service delivery, and policy development for dual diagnosis populations.
Methods: A comprehensive review of evidence was conducted, analysing ten studies comprising seven systematic reviews, one randomized controlled trial, one observational study, and one quasi-experimental study. All studies evaluated integrated care models that combined mental health treatment with substance use interventions.
Results: Integrated care models showed positive outcomes in several areas. Eight studies reported mental health improvements, such as better psychological functioning, less severe PTSD, and fewer psychiatric hospitalizations. Substance use also declined in eight studies, though results varied. Comparative analyses indicated integrated care was more impactful and effective than non-integrated or parallel models in reducing hospitalizations, arrests, and crisis service use.
Conclusion: Successful program implementation involves components such as on-site mental health care, staff training, intensive case management, motivational strategies, individualized plans, and co-located services. Future research should evaluate the independent impact and cost-effectiveness of these elements, and inform sustainable, evidence-based policies for long-term rehabilitation success. A comprehensive and innovative approach is essential to improve outcomes for this complex patient group.
