"Among the 2.6 million adults who had co‑occurring SMI [Serious Mental Illness] and an SUD [Substance Use Disorder] in the past year, 65.6 percent received either substance use treatment at a specialty facility or mental health care in the past year (Figure 31). Stated another way, about 1 in 3 adults with co‑occurring SMI and an SUD did not receive either type of care in the past year.
"In this study, the highest levels of comorbidity (six or more comorbid conditions) among veterans were observed among treatment seekers. However, only those with comorbid DUD [Drug Use Disorders] were significantly more likely to seek treatment for PTSD once potentially confounding factors were accounted for. It is of concern that, in the present sample, 32% of veterans with PTSD who did not seek treatment had 6+ comorbid conditions.
"In the 2015 reporting period, mental health diagnoses among individuals served who had co-occurring mental health and substance use disorders differed very little by substance use diagnosis. (Unlike mental health diagnoses, where up to three diagnoses are recorded per client record, each client record contains only one substance use diagnosis. See the final section of Appendix E for definitions of substance abuse codes.)
" Bipolar disorders were the most frequently reported mental health diagnoses for individuals served who had co-occurring marijuana dependence (29 percent).
"For the 2015 reporting period, states reported a total of 720,987 individuals served aged 12 and older (14 percent of all individuals served) had co-occurring mental health and substance use disorders.
"During this period, the data show that mental health diagnoses differed somewhat across categories for several variables, including gender, age group, race, ethnicity, living arrangements, employment and detailed “not in labor force,” service setting, and timing of admission. Mental health diagnoses were largely similar across SMI/SED status and level of functioning.
"A total of 720,987 individuals aged 12 and older with co-occurring mental health and substance use disorders were served in 2015 [Table 6.1a].
" Among males who had co-occurring mental health and substance use disorders served in the 2015 reporting period, the most frequently reported diagnoses were depressive disorders and schizophrenia and other psychotic disorders (25 percent each); for females, they were depressive disorders (33 percent) [Table 6.1c].
"We generally found significant associations between 12-month and lifetime AUD and other substance use disorders, major depressive disorder, bipolar I disorder, specific phobia, and antisocial and borderline PDs when we controlled for sociodemographic characteristics and other disorders. Significant associations between persistent depressive disorder, posttraumatic stress disorder, panic disorder, and generalized anxiety disorder with lifetime AUD were also observed.
According to a census of courts in the US:
Substance abuse treatment services are provided to clients in 86.8% of all courts overall, 95.5% of all drug courts, and 77.1% of all mental health courts.
Integrated substance abuse and mental health treatment services are provided to clients in 60.4% of all courts overall, 62.5% of all drug courts, and 85.5% of all mental health courts. Medication as a treatment strategy is available in 28.1% of all courts overall, only 22.5% of all drug courts, and 59.9% of all mental health courts.