Concurrent (dual mental health and substance use) disorders

Concurrent disorders is a term used to describe concerns with both substance use and mental illness happening at the same time.

Here are a few examples of what concurrent disorders look like: a person might be dealing with an anxiety disorder and often over-drinks alcohol; or has schizophrenia and uses cocaine regularly; or has a diagnosis of borderline personality disorder while also using heroin.

Concurrent disorders may also be called:

Concurrent disorders can show up in a lot of ways. The disorders may be active at the same time or at different times, presently or in the past, and the symptoms may get worse over time.

People often ask, “What came first – the mental health stuff or the substance use?” This is a hard question, with no straight-forward or simple answer. It can be really useful to think of concurrent disorders as independent problems that interact with each other.   

Concurrent disorders are often related, with each concern impacting the other. Mild to moderate concerns can often be addressed with a family doctor or with community-based substance use counselling.

When both concerns are more serious, specialized care may be required to treat both disorders in a hospital care or residential setting.

People with concurrent disorders have the best success when both concerns are addressed at the same time, with service providers working together. This approach to addressing both mental health and substance use concerns is referred to as integrated treatment.

Integrated treatment is a way of making sure that individuals receive services in a smooth way, addressing things that might get in the way of them being successful. All services involved work together to support and help the individual – in all areas that contribute to one’s well-being and health. Different people may get psycho-social support (includes social and psychological, emotional and other supports), individual or group therapy, biological treatment (medication), or a combination of therapies.

Integrated treatment goes beyond just helping with the concurrent disorders, but also includes getting supports in other challenging areas of life, such as housing or employment.

Each person’s goals for treatment are unique and specific. There is never a perfect “one-size-fits-all” treatment plan, since each person’s challenges, as well as strengths and supports, differ. General goals for treatment of concurrent disorders may look like:

• Exploring what a healthy future means or looks like for the individual
• Identifying the way they want to live and how they want to be helped

Integrated treatment works to address obstacles or concerns that have been identified by the individual. Professionals focus on listening and really understanding the person’s experience, working to identify how they can help.