Co-Occurring Mental Health and Substance Use Disorders

Co-OccurringMental Health and Substance Use Disorders

TheFour Types of Health Care Service Settings

Thefour types of health care service settings include: primary healthcare settings, secondary and tertiary settings, Restorative caresettings, and continuing care settings. Each of these types ofsettings have unique components and implementation issues.

Primaryhealth care settings are health care services that provide essentialcare using methods that are socially and scientifically acceptable(Hendrickson,2013). It is the type of care service setting in which families andcommunities are provided with universal access to health care. Theyare developed at affordable costs and full participation of thecommunity in order to enhance development of healthcare systemthrough self-determination and self-reliance. The purpose of theprimary care settings is to reduce exclusion in healthcare and betterhealth services are provided for all. One of the issues associatedwith its implementation is the influence of universal coveragereforms and other legal and political policies that may accelerate orslow down the pace of implementation(Hendrickson,2013). There are also things that may need resources to implement,including the physician’s office, ambulances, community healthawareness and health clinics.

Secondaryand Tertiary settings are specialized consultative care settingswhere by healthcare services are provided for patients referred fromprimary health care settings. They address diseases or injuries thathave occurred. It aims at halting or reducing the progress of anillness(Hendrickson,2013). These settings are usually characterized by regularexamination of patients, exercise programs and rehabilitation. Themajor issue with implementation of secondary and tertiary health caresettings is that they need a lot of resources including buildingrehabilitation centres and screening devices. It also requires highlyqualified and knowledgeable health care personnel to implement.

Restorativecare settings involve the provision of ongoing nursing or health careservices in long term and skilled health care facilities referred toas nursing homes. This is usually done after rehabilitation.Restorative care is provided by paraprofessional and licensedcaregivers to enhance optimal functioning and independence ofpatients(Hendrickson,2013). Restorative settings include inpatient and outpatientrehabilitation, homecare, and SNF. Its implementation includes issuessuch as training, safety, and regular assessment. The nursing andtherapy assistants often require training. These assistants alsotrain and engage people in order to enhance participation.

Lastly,continuing care settings refer to extended care services providedoutside the hospital to promote good health for patients. Thesesettings are provided anywhere outside hospital including home andregistered care homes. Continuing care services are available tochildren, adults, and young people who suffered injuries,disabilities or illnesses that cannot be adequately covered byexisting universal healthcare in other settings(Hendrickson,2013). One of the issues in implementation is that continuinghealthcare providers have to assess whether a person is eligible forthis healthcare setting. This is determined if the person has primaryhealthcare need that requires continued care services. Eligibilitydepends on assessed needs rather than a condition or diagnosis.

Skills,Knowledge, and attitudes of staff providing care to individuals withco-occurring disorders

Staffproviding healthcare services to people with co-occurring disordersshould demonstrate essential skills and knowledge. As suggested byHendrickson (2013), staff should have knowledge and skills about thetype of drugs and their effects on their clients. The staff shouldalso be knowledgeable about the process of administering tests suchas urine screens and breath tests. Apart from this professionalknowledge, the staff should also demonstrate good attitude byunderstanding the nature of addiction and should not feel offendedwhen patients go back to cravings and compulsions due to high levelsof addiction. Furthermore, the staff dealing with substance usedisorders should learn how mental disorders relate with drug abuse.Substance use disorder therapists should also understand how thesedisorders affect the social skills and social functioning of theirpatients in the community.

Thestaff dealing with substance use and mental disorders also needs tohave knowledge about the medications needed for the treatment ofthese disorders (Hendrickson,2013).The therapists also need to have skills of identifying the sideeffects of the medications. Leadership skills are also needed so thatthe staff can promote compliance on the medication by patients. Theseskills will also enable them to handle negative values of clients,their families, groups, and other professionals in the field aboutthe medications of drug abuse and mental disorders. To develop theright attitude in this kind of environment, the staff should learnthe culture and purpose of the clients’ self-help groups.

Thestaff working with mental health disorders should know the importanceof abstinence while those working with substance abuse disordersshould learn the importance of medication. Those who deal with mentalhealth disorders should also know how to handle self-disclosureenvironment while those working with substance abuse shouldunderstand how to maintain clear boundaries. The therapist or staffof mental health disorders should be directive, confrontive andconcrete (Hendrickson, 2013). Those working with individuals havingsubstance abuse disorders should be less directive and more flexible.


Hendrickson,E.L. (2013). Designing,Implementing, and Managing Treatment Services for Individuals with.New York: Routledge.