People with co-occurring mental health and substance use disorders (SUDs) benefit from integrated treatment to address both disorders concurrently. For several decades, policymakers and behavioral health systems have worked to overcome the historical separation between mental health and SUD treatment to improve care for people with co-occurring disorders. Such efforts could translate into changes over time in the availability of integrated care for co-occurring disorders. We used data from the National Mental Health Services Survey and the National Survey of Substance Abuse Treatment Services to examine changes from 2014 to 2020 in the proportion of outpatient behavioral health facilities with a special program for co-occurring disorders, and we identified the characteristics of facilities with these programs. In 2020, 54% of outpatient mental health facilities and 53% of outpatient SUD facilities had a special program to provide integrated care for co-occurring disorders. This represented no change from 2014 for mental health facilities but a 10-percentage point increase for SUD facilities. The findings varied substantially by state; special programs for co-occurring disorders were much more common in mental health than SUD facilities in some states than others, and some states experienced greater changes over time in the proportion of facilities with these special programs. For both mental health and SUD facilities, special programs for co-occurring disorders were more common among facilities accredited by the Joint Commission and among facilities with a wider range of other special programs for specific populations. Other facility characteristics, including profit status, other forms of accreditation, and acceptance of Medicaid, were also associated with the presence of special programs for co-occurring disorders but differed between mental health and SUD facilities. Depending on the state, efforts to bolster the availability of integrated care programs for co-occurring disorders could be directed toward either mental health or SUD facilities, and facilities with specific features.
This research was funded by HHS/ASPE’s Office of Behavioral Health, Disability, and Aging Policy (BHDAP). Additional research in this area is available at the ASPE Behavioral Health page.
Available Reports:
- Adoption of Integrated Care for People with Co-Occurring Mental Health and Substance Use Disorders
- Availability and Correlates of Integrated Treatment for People with Co-Occurring Disorders in Outpatient Behavioral Health Treatment Facilities Issue Brief
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