Presentation for Practice II, Spring 2016.

1. Clinical Implications for MICA Clients
and their Co-Occurring Disorders
Kristen Gruenfelder
Silver School of Social Work
New York University

2. MICAstands for…

3. MICAstands for…
M Mental
I Illness
C Chemical
A Addiction / Abuse

4. MICAstands for…
M Mental
I Illness
C Chemical
A Addiction / Abuse
What does
that mean?

5. MICA clients suffer from co-
occurring disorders or dual
diagnoses, which are defined as…

6. MICA clients suffer from co-
occurring disorders or dual
diagnoses, which are defined as…
“…having a diagnosis of a mental illness along
with a substance abuse disorder.”
(Woldin, 2015)

7. MICA clients suffer from co-
occurring disorders or dual
diagnoses, which are defined as…
“…having a diagnosis of a mental illness along
with a substance abuse disorder.”
(Woldin, 2015)

8. What separates dual-diagnosis
clients from non-MICA clients?

9. MICA clients require more:
Emotional support
- may lack this due to
stigma of one or both
conditions
- empowering
Medication management
Unique sensitivity and
empathy to their situations
- Many combinations of
mental illnesses and
chemical addictions
Cognitive considerations

10. MICA clients are often:
More receptive to treatment
- ex: have had previous
experiences with a
helping professional
Cohesive together
- know they relate through
their mental illnesses
- feel safe, trusting
Impacted by medication
- drowsiness, over
stimulated, lack of focus

11. Has there been an increase in
awareness of mental illness and
treatment options within the past
few decades?

12. Has there been an increase in
awareness of mental illness and
treatment options within the past
few decades?
Kfdrk f
FOR EXAMPLE:
The amount of
college students
seeking mental
health treatment
is growing
rapidly!

14. 20.2 million adults with substance abuse disorders
7.9 – 8.9 million adults with co-occurring disorders
A little less than half of all substance abusers suffer
from mental illnesses!
STATISTICS!

15. 8.9 million U.S. adults with co-occurring disorders
44% received substance abuse OR mental health treatment
13.5% received both treatments
37.6% received NO TREATMENTS!
STATISTICS!

16. For those in treatment:
-- dual-disorder treatment unavailable
-- many locations provide mental health services but
not substance abuse services
-- ex: only 10% of agencies providing mental health
services provide dual treatments (Gotham, 2013)
For those not in treatment:
-- dual-disorder treatment uncommon

17. For those in treatment:
-- dual-disorder treatment unavailable
-- many locations provide mental health services but
not substance abuse services
-- ex: only 10% of agencies providing mental health
services provide dual treatments (Gotham, 2013)
For those not in treatment:
-- dual-disorder treatment uncommon
What is keeping these individuals from
seeking out treatment?

18. Case Example #1 – Justin

19. Case Example #2 – Alisha

20. Case Example #3 – Shellie

21. Benefits of Dual Treatment
• Seeing separate specialists for both diagnoses,
coordination of care and team collaboration
• Development of coping skills for both disorders
• Awareness on the importance of medication
management, and understanding how using may
intensify mental health symptoms
• Receive supportive therapy that reinforces self-
esteem and builds self-confidence
• Inclusive treatment options: bringing in partners,
children, and etc. for counseling and education

22. Why does this matter?
• You’re now informed of a
population that is often
overlooked in terms of funding
• General lesson: can’t intervene
or treat everyone the same way
• Your awareness can allow you to
advocate for a group that may
be unable to advocate for itself

23. For more information
http://www.samhsa.gov/
http://oasas.ny.gov/
http://omh.ny.gov/

24. ReferencesBalyakina, E., Mann, C., Ellison, M., Sivernell, R., Fulda, K., Sarai, S., & Cardarelli, R. (2014).
Risk of Future Offense Among Probationers with Co-occurring Substance Use and
Mental Health Disorders. Community Mental Health Journal,50(3), 288-295 8p.
Clark, H. W., Power, A. K., Le Fauve, C. E., & Lopez, E. I. (2008). Policy and practice
implications of epidemiological surveys on co-occurring mental and substance use
disorders. Journal Of Substance Abuse Treatment, 343-13. doi:10.1016/j.jsat.2006.12.032
Gotham, H., Brown, J., Comaty, J., McGovern, M., & Claus, R. (2013). Assessing the Co-
occurring Capability of Mental Health Treatment Programs: the Dual Diagnosis Capability
in Mental Health Treatment (DDCMHT) Index. Journal Of Behavioral Health Services &
Research, 40(2), 234-241. doi:10.1007/s11414-012-9317-8
Guerrero, E. G., Andrews, C., Harris, L., Padwa, H., Kong, Y., & M.S.W., K. F. (2016). Improving
Coordination of Addiction Health Services Organizations with Mental Health and Public
Health Services. Journal Of Substance Abuse Treatment, 60 (Special Issue on Studies on
the Implementation of Integrated Models of Alcohol, Tobacco, and/or Drug Use
Interventions into Medical Care), 45-53. doi:10.1016/j.jsat.2015.08.002
Priester, M. A., Browne, T., Iachini, A., Clone, S., DeHart, D., & Seay, K. D. (2016). Treatment
Access Barriers and Disparities Among Individuals with Co-Occurring Mental Health and
Substance Use Disorders: An Integrative Literature Review. Journal Of Substance Abuse
Treatment, 6147-59. doi:10.1016/j.jsat.2015.09.006
Woldin, B. B. (2015). Co-occurring disorders. Salem Press Encyclopedia Of Health.