Information Sharing

Tracking and Assessing Services for People with Concurrent Disorders

By Lisa Kofod

Overview:

“People with a mental illness are twice as likely to have a substance use disorder compared to the general population (16%). At least 20% of people with a mental illness have a co-occurring substance use disorder. For people with schizophrenia, the number may be as high as 50%.” (The Centre for Addiction and Mental Health, 2025).

For people with Schizophrenia, developing an addiction dramatically worsens overall clinical outcomes. A number of studies have shown that such high rates of substance use disorders in people with Schizophrenia also experience additional significant negative impacts on such things as “non-compliance with treatment, poor global functioning, violence, suicide and increased rates of relapse and re-hospitalization”. (National Library of Medicine: Khokhar JY, Dwiel LL, Henricks AM, Doucette WT, Green AI. The link between schizophrenia and substance use disorder: A unifying hypothesis. Schizophr Res. 2018 Apr;194:78-85.)

The Problem:

Identifying best practices for the treatment of people with Schizophrenia and substance use disorders has long been a challenge. Traditionally, individuals are treated for one or the other, but not both. The few facilities that exist for the treatment of Concurrent Disorders do not have adequate assessment in place for understanding effectiveness for this population. Without substantial knowledge of the effectiveness of available treatment options, how can we be assured that we are offering the best hope for our loved ones who suffer from these debilitating illnesses?

Our experience as a family with a loved one with Schizo-affective Disorder and addiction to opioids, is that there is no follow-up for patients who have been in and out of treatment facilities. It is assumed that services and programs exist where he lives, however in rural British Columbia, the resources are scarce if they exist at all. This lack of services, programs, and follow-up has a direct and negative impact on treatment outcomes and recovery.

Research Avenues:

Determine the scope of services and programs for people with Schizophrenia and other disorders on this spectrum.
Determine how many of these services and programs also incorporate the needs of individuals who also have a Concurrent Disorder, such as drug addiction.
Determine how these services and programs are being assessed currently.
Identify gaps in data gathering, for example are families and clients being asked for input into outcomes?
Create comprehensive follow up opportunities, such as electronic data gathering, in order to understand which services and programs are actually benefiting this population.