Are there treatment plans that can address both SMI and any substance use or co-occurring disorders at the same time?

Integrated approaches are treatments that address co-occurring mental health and substance use disorders and account for their bidirectional and complex interplay. Through integrated assessment, individuals and clinicians can better understand the role that mental illness plays on substance use, and vice versa. Integrated approaches have been successfully used in a variety of services, such as case management and assertive community treatment.

Overall, data on integrated treatment are not definitive. However, they do suggest that integrated treatment increases the probability that persons with schizophrenia and co-occurring disorders have better treatment participation. They may also have some reductions in substance use, more days in stable housing, and greater reductions in psychiatric hospitalization and arrests.

Learn more about common myths around SMI and treatment, including co-occurring disorders. See our infographic on this topic.



Substance Abuse and Mental Health Services Administration, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, Mental Health, Detailed Tables available at:, 2021.

Kreyenbuhl J, Nossel IR, Dixon LB: Disengagement from mental health treatment among individuals with schizophrenia and strategies for facilitating connections to care: a review of the literature. Schizophr Bull 35:696-703, 2009

Dixon LB, Holoshitz Y, Nossel I: Treatment engagement of individuals experiencing mental illness: review and update. World Psychiatry. 15:13-20, 2016

Substance Abuse and Mental Health Services Administration. Substance Use Disorder Treatment for People With Co-Occurring Disorders. Treatment Improvement Protocol (TIP) Series, No. 42. SAMHSA Publication No. PEP20-02-01-004. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2020.

Mueser KT, Noordsy DL, Drake RE, Fox L (2003). Integrated treatment for dual disorders: A guide to effective practice. New York, NY, US, The Guilford Press.

Essock SM, Mueser KT, Drake RE, et al: Comparison of ACT and standard case management for delivering integrated treatment for co-occurring disorders. Psychiatr Serv 57:185-196, 2006

Dixon LB, Dickerson F, Bellack AS, et al. The 2009 schizophrenia PORT psychosocial treatment recommendations and summary statements. Schizophr Bull. 2010;36(1):48-70. doi:10.1093/schbul/sbp115

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