Persons with dual diagnoses of psychiatric illness and substance abuse represent a large subpopulation within the mental health system, but mental health service delivery systems typically do not adequately address their special needs.
The literature on dual diagnoses is marked by the paucity of information on such persons in rural settings.
This paper describes the characteristics of a rural community mental health system, which illustrate the difficulties in treating persons with dual diagnoses in rural communities.
These problems include a fragmented system of services, centralized services in a large geographic area, overly restrictive regulations, conceptual differences in treatment approaches, confidentiality and stigma in a rural culture, and the academic and professional isolation of mental health workers, leading to high turnover and a shortage of staff having sufficient training and experience to work with persons with dual diagnoses.
Some recommendations to address these problems and to improve the delivery of services to persons with dual diagnoses are suggested.
Mots-clés Pascal : Association morbide, Trouble psychiatrique, Toxicomanie, Alcoolisme, Traitement, Milieu rural, Système santé, Organisation santé, Pennsylvanie, Etats Unis, Amérique du Nord, Amérique, Homme
Mots-clés Pascal anglais : Concomitant disease, Mental disorder, Drug addiction, Alcoholism, Treatment, Rural environment, Health system, Public health organization, Pennsylvania, United States, North America, America, Human
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 95-0139089
Code Inist : 002B18H05B. Création : 09/06/1995.