ABSTRACT
The high prevalence of the dual diagnosis of psychiatric/mental disorders and substance use disorders (SUDs) has been increasingly documented for both adolescents and adults (Crowley & Riggs, 1995; Kandel et al., 1999; Whitmore et al., 1997). For more than a decade, the National Institute of Drug Abuse (NIDA) has included integrated treatment of co-occurring psychiatric disorders as one of nine core treatment principles. Despite empirically supported practice guidelines, implementation of integrated treatment has been slow (New Freedom Commission on Mental Health, 2003; U.S. Department of Health and Human Services, 1999). In response to the growing call for integrated treatments and systems of care for adolescents with cooccurring psychiatric disorders and SUDs, this chapter (1) identifies three systemic and economic barriers that have impeded widespread implementation of integrated care: the supply of treatment providers; shifting priorities of gatekeepers to specialty care; and financing streams; and (2) describes possibilities for aligning economic incentives in order to facilitate the dissemination and implementation of integrated care.
