Dual diagnosis

Abstract The term “dual diagnosis” is used to describe an individual with both a mental illness and a substance use disorder. These two disorders cluster in various ways, making those with dual diagnosis a dynamic population with a complex set of needs. The prevalence of both mental illness and substance use disorder is much higher in justice-involved populations, resulting in increased numbers of individuals with dual diagnosis. The general treatment literature provides guidance regarding best practices for treating those with dual diagnosis. This research suggests taking a multidimensional approach, combining pharmacological and psychosocial interventions, and using an integrated treatment model. Research is still lacking on the unique treatment needs of the justice-involved population and how best to address these needs within the limitations of the criminal justice context. Many of the most promising treatments have not been evaluated for their impact on substance use, mental health, and criminal outcomes. This chapter describes the characteristics of the dual diagnosis population, reviews current knowledge about effective treatments, and discusses the implementation challenges of treating this population within the criminal justice context.