Working with the Dually Diagnosed and the Role of Medication Stephen Corey, Ph.D. Regional Mental Health Consultant David Kraft, MD Regional Mental Health Consultant

2 Test Positive on Entry Group Test Positive (Alcohol/ Drug) on Suspicion Very High Drop-Out Rate Hurts Center Statistics (unhappy CD) TEAP Group Center Director 1)% of incoming still around 45 days 2)% test negative/ positive – 45 days 3)% dual diagnosis 4)% dual diagnosis successful  45 days 5)% test positives - Completers

3 30%Test Positive on Entry TEAP 30-40% Major Depression 25-50% Anxiety Disorder 50% Behavior Disorder

4 CMHC TEAP CMHC Evaluate/ Refer Physician Evaluation Center Physician/ Psychiatrist Training Referral Vigilance for Psychiatric Disorder Suspected Psychiatric Disorder Health/ Wellness Monitoring Refer

5 Drug/Alcohol Abusing Dependent Applicants Job Corps Stop Using Psychiatric Disorder Becomes Manifest Identified Treated Best Chance at Succeeding Medication Regimen Prompting TEAP Medication Groups End of 45 Day Period Ongoing TEAP Support Psychiatric Monitoring

6 CMHC TEAP Specialist Training in Observing for Psychiatric Disorder Supportive Structure Refer TEAP Specialist CMHC Evaluate/ Refer Physician Evaluation Training Staff

7 CMHC TEAP Specialist Outreach Screening Quarterly Teleconference Education focused toward determining drug/alcohol abuse/dependency, psychiatric disorder, behavior disorder, and dual diagnosis

8 Attendees: CMHC, TEAP Specialist, Manager of Counseling, Counselors, Manager of Residential Living, CSO, and Health and Wellness Manager NAME: Behavioral Observations: Drug/Alcohol Issues: Psychiatric Issues: Plan (Goals): Followup: Weekly Staffing Evaluation Form