Imagine a young girl who has known nothing but chaos and neglect. Rather than having a home filled with warmth and safety, she is only met with cold indifference. Each day is marked by uncertainty, with the constant threat of abuse casting a dark shadow over her entire existence. At school, she struggles to connect with her peers, feeling like an outsider. None of the other children seem to understand what she’s going through.
As the years go on and she begins to navigate her teenage years, the weight of these early traumas morphs into something more sinister. Isolation, neglect, and abuse transform into anxiety, depression, and post-traumatic stress disorder. Desperate for relief, she seeks solace in substances, hoping to numb the pain and escape her reality. What begins as a fleeting reprieve quickly spirals into a dependency, leading her down a road of chronic addiction, where the cycle of suffering continues to tighten its grip.
This story illustrates the frequent intersection of Substance Use Disorders (SUDs) and mental health disorders. It’s evident that SUDs rarely occur in isolation—mental health disorders are often intricately linked and play a more significant role than previously recognized. This raises the crucial question: how deeply are these two conditions integrated?
The Link Between Mental Health and SUDs
Jon Schlenske, Division Chief of Substance Use Disorders at Comprehensive Healthcare, states there’s a near-universal overlap between SUD and mental health disorders. “We’re finding more out now in regards to childhood trauma and childhood neglect, trauma in general, especially early in life, how that leads to self-medication, which is really the first step in terms of becoming chronically addicted,” Schlenske explains.
Several risk factors contribute to the development of both SUD and mental health disorders. As mentioned earlier, these include genetic, environmental, and social factors. Schlenske points out that negative family systems, childhood abuse, neglect, and a lack of emotional support during formative years can set the stage for these co-occurring conditions. Additionally, social determinants of health, such as inadequate access to basic needs, play a crucial role.
“Sliding into a negative peer group, trying to find your place, or just ultimately numbing the pain because you haven’t been able to get help” are common pathways leading to SUD and mental health issues, Schlenske notes. While genetics play a role, the foundation of these disorders is often laid by early negative experiences.
Treatment: Evidence-Based Approaches
Treating individuals with co-occurring SUD and mental health disorders requires a multifaceted approach. Schlenske highlights the importance of integrating various evidence-based practices, such as cognitive-behavioral therapy (CBT), dialectical behavior therapy (DBT), and motivational interviewing. These methods are crucial in addressing the intricate needs of individuals facing both substance use and mental health disorders.
The average addict enters inpatient seven times before they generally attain one year of sobriety.
Jon Schlenske, Division Chief of Substance Use Disorders at Comprehensive Healthcare
Despite the effectiveness of these treatments, Schlenske points out the concurrent challenges in treating these disorders. “The average addict enters inpatient seven times before they generally attain one year of sobriety. Relapse rates are in the 80 percentile. For opioids, it’s even higher than that,” Schlenske shares. This high rate of relapse underscores the importance of a structured and phased approach to treatment. “Typically, you want to treat the SUD first so they can stabilize and get a good recovery foundation,” he advises. This method helps prevent premature dives into trauma that could destabilize recovery, ensuring a more stable and sustainable path to wellness.
Barriers to Treatment: A Complex Landscape
Accessing timely and adequate treatment remains a significant hurdle for those with an SUD.
“Bed availability, wait times, access issues, insurance issues. Wait times are a barrier. Folks are months out,” Schlenske states. Post-COVID, these issues have intensified due to a shortage of healthcare workers, making access to treatment even more difficult. Additionally, transportation and childcare can further complicate access to care for Medicaid populations, as these individuals often lack the resources needed to attend appointments regularly.
Long wait times can be particularly discouraging for individuals in crisis. “If you’re in a crisis and you finally reach that point where you really want to address this and you reach out, and they say, ‘We can see you in six weeks,’ it makes it pretty difficult,” Schlenske shares.
“We want to get folks in, and we don’t want to make them wait,” Schlenske stresses. Streamlining assessments and reducing wait times are essential to removing those barriers to care.
Advice for Those Struggling: Persistence Is Key
For those struggling with both SUD and mental health issues, Schlenske’s advice is clear: “Reach out. Don’t stop. Make phone calls. Don’t take no for an answer.” He stresses the importance of utilizing community resources and hotlines, emphasizing that help is available for those who persist in seeking it.
Looking Ahead: Integrated Care for Better Outcomes
Jon Schlenske’s role as Division Chief of Substance Use Disorders is a new position to Comprehensive Healthcare, created as a proactive approach to addressing the SUD crisis. This move aligns with the agency’s strategic vision to improve its infrastructure and enhance the delivery of whole-person care. Comprehensive Healthcare has also recently hired a full-time addictionologist, further signaling a strengthented commitment to treating co-occurring disorders and advancing the integrated care model. Schlenske is optimistic about this new direction. “I’m thrilled that we are valuing co-occurring disorders like we are now,” he says. This shift towards holistic care and concurrent treatment marks a significant progress in the healthcare system. By acknowledging and addressing the intertwined nature of SUD and mental health disorders, providers can now offer more effective and compassionate care.
