The two main obstacles to addiction and mental health treatment for people with co-occurring disorders are personal characteristic barriers, such as psychosis, and structural barriers, such as finances, an integrative review published in the Journal of Substance Abuse Treatment found.
Researchers from the College of Social Work, DeSaussure College and University of South Carolina studied 10 different databases, 24 experiential articles and 9 theoretical articles before they identified the two broad categories of treatment access obstacles faced by people with a diagnosed co-occurring disorder, which is where a patient has met medical requirements for at least one substance use disorder and one mental health disorder.
Out of the 36 articles included in the review, 15 mentioned personal characteristics as an impediment to substance abuse treatment for individuals with co-occurring disorders.
The review separated personal characteristic barriers into two groups: personal vulnerabilities and beliefs.
Symptoms related to either the coexisting substance use disorder or the mental illness — such as psychosis or debilitated social abilities — were defined as personal vulnerabilities, as they tend to aggravate general vulnerabilities of a person.
Individual beliefs were described essentially as opinions about treatment providers, cultural beliefs, attitudes and stigmas regarding mental illness or substance abuse disorder.
Structural barriers were reported by 30 of the articles as obstacles to substance abuse treatment among populations suffering from co-occurring disorders. The review determined that availability of services was the most prominent structural barrier. Other structural barriers included service location, disorder determination, financial factors such as insurance coverage or settlements, and racial disparities.
Researchers emphasized that there are “notable racial and ethnic disparities” in addiction treatment access for individuals with co-occurring disorders.