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Mental health and substance abuse

I recently read a commentary published in The Sun in reference to outpatient civil commitment for mental illness and then a physician's response to this research along with another letter to the editor ("Budget cuts will hurt mental health providers," Jan. 13).

I do not disagree with the information they reported, but I find it difficult to understand how substance use was totally disregarded in any of this written communication, especially when an organization calls itself a Community Behavioral Health Association and writes only about mental health budget cuts.

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The word "behavioral health" is defined by The Substance Abuse and Mental Health Services Administration as a general term that encompasses the promotion of emotional health; the prevention of mental illnesses and substance use disorders; and treatments and services for substance abuse, addiction, substance use disorders, mental illness and/or mental disorders.

A National Alliance on Mental Illness report reviewed by Dr. Robert Drake of Dartmouth University states, "For the consumer, the consequences are numerous and harsh. Persons with a co-occurring disorder have a statistically greater propensity for violence, medication noncompliance, and failure to respond to treatment than consumers with just substance abuse or a mental illness." It is the expectation, not the exception.

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Therefore, behavioral health professionals and the Department of Health and Mental Hygiene's Behavioral Health Administration should be making every effort to move away from treatment fragmentation and toward true system integration. This will only be accomplished if all are talking the same language and assuring that policy and regulations reflect this expectation.

Patricia Miedusiewski, Monkton

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