You want to know the single biggest problem in mental health treatment today?
Dual diagnosis.
Treating mental illness while completely ignoring substance use. Treating substance abuse while never asking about anxiety or depression.
Providers have been doing this for YEARS. Splitting it into two completely different problems that need to be treated separately.
And guess what…
It’s not working very well.
See, the truth is these two things feed into each other. If someone is mentally unhealthy and uses substances to cope, it’s just going to make both problems worse.
So why not treat them together from the beginning?
In this article the top reasons mental health treatment needs to start addressing substance use from day one are broken down.
Plus how to actually make sure it happens.
What you’ll learn:
- Why Mental Health and Substance Abuse Are Linked
- Why Starting Treatment “After” Isn’t Ideal
- How To Know If Someone Needs Treatment
- Why IOP is One of The Best Options
- Things That Make Treatment Hard
- How To Actually Get Help
Let’s dive in.
Why Mental Health And Substance Abuse Are Linked
Here’s the deal…
Mental illness and substance abuse almost always occur together. When they do occur together it’s called a “co-occurring disorder” or “dual diagnosis”.
Per SAMHSA’s 2024 national survey, approximately 21.2 million adults in the United States had both a mental illness and a substance use disorder. That’s a LOT of people.
Addiction does not discriminate.
Here’s another way to look at it:
Many people who suffer from anxiety or depression begin drinking or using drugs to feel better. Or at least that’s what it seems like at the moment.
Over time, the substance abuse alters their brain chemistry and makes their mental illness much worse.
The same is true if someone starts abusing substances first. Substance abuse has been shown to trigger mental illness symptoms that may not have been present before.
Eventually, a person can end up having both disorders at the same time.
Which is exactly what happens most of the time.
According to NAMI’s 2025 data
34.5% of adults with mental illness also have a substance use disorder.
So if someone is walking into any kind of mental health treatment, at least one-third of the people sitting next to them also need substance abuse help.
Why Starting Treatment “After” Isn’t Ideal
So someone is mentally unhealthy starts using substances to cope. But then they finally decide to get help and treatment doesn’t address their substance abuse.
What’s the problem with that?
Treatment takes time.
Let’s say a person starts out abusing alcohol but during mental health treatment their provider figures it out.
If the provider doesn’t address that alcohol abuse until “after” treatment, that person is looking at months (maybe years) of recovery before they actually get help with their alcoholism.
Which is NEVER a good idea.
Here’s why addressing both problems early on is so important:
- It stops substance abuse from getting worse. Early intervention prevents a bad situation from becoming unmanageable.
- Treatment works better. When both disorders are treated together recovery happens faster.
- There is a lower chance of relapsing. Relapse is far less likely when two birds are being knocked out with one stone.
Screening for substance abuse should be done by every mental health provider during their initial assessment.
SAMHSA even recommends a “no wrong door” approach to treatment. Walking into any mental health provider should automatically trigger a screening for substance abuse and vice versa.
The earlier it gets caught and addressed within treatment the better.
Why IOP is One of The Best Options When Dealing With Dual Diagnosis
Alright so integrated treatment is obviously the way to go.
But what does that actually look like?
Good question.
An intensive outpatient program like the ones offered at changingtidesobx.com is one of the best treatment modalities for someone struggling with mental illness as well as substance abuse.
Why?
It’s simple. These programs treat the whole person instead of just one aspect of their illness.
Let’s break down exactly how an IOP tackles both mental illness and substance abuse:
Unlike inpatient programs or rehab there is no being stuck in a hospital setting for months on end.
An intensive outpatient program will provide structure through group counselling, cognitive behavioural therapy, motivational interviewing, relapse prevention, and more.
Programs like Changing Tides sober living combine ALL of these treatment types to create a seamless, integrated plan of attack.
Everything needed to succeed can (and will) be found in an IOP.
Things That Make Integrated Treatment Difficult
OK but as mentioned earlier. If it’s the best thing, why doesn’t everyone do it?
Here’s the thing.
There are barriers.
Yes, even in the year 2025 integrated treatment isn’t always easy to get.
That being said…it’s getting there. Mental health and addiction treatment are beginning to merge together more and more. Clinicians are getting trained in dual diagnosis and more insurance plans are covering intensive outpatient programs.
Until then, here are some common barriers people face when trying to get proper treatment:
- Stigma surrounding substance abuse
- Mental health and addiction treatment have been separate for so long they operate independently
- Not enough clinicians are trained to treat both disorders at the same time
- Lack of availability and insurance coverage
- Rural vs. urban access gaps
But hey, things are getting there. Just be aware that there may be some obstacles when searching for the right treatment.
How To Actually Get Help For Mental Health AND Substance Abuse
Alright, so this article has covered how important it is to get help for both mental health and substance abuse. Great.
Now what does someone actually do about it?
Here are a few tips to take away from this article.
Be Honest.
If someone is receiving mental health treatment they need to tell their provider about any substance abuse. Similarly, if someone is getting help for addiction they should tell their provider about any mental health symptoms.
Don’t be afraid to speak up about what’s going on.
Ask Questions.
Will the treatment center screen for substance abuse? If not, ask if they will.
Providers should be screening for both mental illness and substance abuse from day one.
Look for Dual Diagnosis or Integrated Treatment Centers.
Integrated treatment works best. Make sure that the treatment center specializes in dual diagnosis or in treating both mental illness and substance abuse.
For most people, that’s going to look like an intensive outpatient program.
Find A Support System.
Recovery cannot be done alone.
Part of integrated treatment should involve support groups, family therapy, and finding the right people. A support network is just as important as the treatment itself.
Don’t Give Up!
Recovery takes time, there is no shortcut. But staying committed while both disorders are being treated properly leads to real results.
Wrapping Up Why Mental Health Treatment Should Address Addiction
Treating mental illness without addressing substance abuse is only treating half the problem.
Both disorders frequently occur together and usually make one another worse. When someone begins using substances to cope with their mental illness they’re only digging into a deeper hole.
Make sure that if/when the decision is made to seek mental health treatment, the right questions are asked and there is a full understanding of what the provider will and will not treat.
Here’s a recap:
- Mental health and substance abuse are commonly linked
- Addressing substance abuse early improves treatment outcomes
- Dual diagnosis treatment centers offer the most integrated care
- Some barriers to integrated treatment still exist
- Ask questions and be honest with providers
The sooner substance abuse is addressed within mental health treatment the better. Don’t wait until “after” to get help with addiction.
Start sooner rather than later and give recovery the best possible foundation!
