In the mental health/therapy field, a patient is described as having a "dual diagnosis" when they present with both a mental health disorder (bipolar disorder, schizoaffective disorder, borderline personality disorder, etc.) and a substance abuse problem. These patients are difficult to treat under traditional therapeutic models.

Dual diagnosis is interesting because of its chicken-egg questions. What comes first, mental health problems or substance abuse? It is hard to tell because those with mental health problems first, sometimes self-medicate with drugs on their own which creates the dependency. Meanwhile, drug addicts if they use their chemical of choice for a long period of time, or mix drugs together, can begin to experience symptoms that look like those associated with mental health disorders.

Is it important to know which one came first? Not really. People who offer dual diagnosis services (described below) treat both parts of dual diagnosis as equal parts of the problem, and regardless of which came first, both need to be treated.

Traditionally, a mental health worker is experienced with mental health issues and not with drug and alcohol treatment, and a drug and alcohol counselor knows about substance abuse, but not much about mental health. The problem with these traditional roles is about 60%1 of those with mental health problems also have some sort of chemical dependency.

As a result, there are dual diagnosis programs that aim to treat both problems at the same time. This is beneficial because both ends of the treatment can be coordinated since one program is offering all the services.

1: The 60% statistic was given to me by a therapist who runs a dual diagnosis treatment community. I do not know where he got that figure, so I can not vouch for its truth. However, given the person I heard it from, I tend to think it's true.

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