Substance Use and Mental Health Disorders: Psychologists' Role in Bridging the Gap

Public Significance Statement Research demonstrates that integrated treatments that address both mental health and substance use problems simultaneously, result in improved clinical outcomes. Yet, the majority of individuals with co-occurring mental health and substance use difficulties do not receive integrated treatments. Herein, we propose that psychologists are ideally suited to bridge this gap in care and outline the barriers and solutions for psychologist to improve care for individuals with concurrent disorders. Nearly 30% of people with a mental health disorder will also have a substance use disorder at some point in their lives. Despite widespread evidence of the complex interactions between mental health and substance use and the value of integrated treatment, the majority of people with concurrent disorders do not receive treatment that addresses both conditions. Psychologists are ideally suited to bridge this gap in care, but this will not be without challenges. Psychologists possess extensive skills in identifying, diagnosing, and treating mental health disorders, which are transferrable to substance use disorders. Psychologists also have formal training in supervision and consultation and thus can supervise or act as consultants for other professionals in treating concurrent disorders. They have expertise in program development, evaluation, and research and can lead projects to integrate mental health and substance use services. Barriers to psychologists bridging this gap center on siloes in our healthcare system, the lack of training for psychologists to develop competency and confidence in substance use disorder diagnosis and treatment, misperceptions about how individuals with substance use disorders respond to psychological treatment, as well as system barriers. Overcoming these barriers comes with clear benefits and will require changes to professional training, clinical practice, and research on evidence-based treatments for concurrent disorders. Agencies across Canada are calling for action to ensure individuals with concurrent disorders receive the integrated services they require. Being at the leading edge of this change offers an important opportunity for psychologists.