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Ping Pong Treatment

by Cindy Hardy ❘  

What Is Ping Pong Treatment?

Gaps in services often result in what has been termed “ping-pong” treatment. Mental health facilities often referred people with co-occurring disorders to addiction treatment facilities, and addiction treatment facilities often referred them back to mental health facilities. People often remained in one system or another without fully addressing either problem or finally fell into the gap dividing the two systems.

In these situations, jails and hospitals often became the main institutions for the dully-diagnosed. Furthermore, reimbursement practices often slowed down or even blocked the integration of services and effective integrated treatment because of a number of problems that can include: separation of monies for addiction and psychiatric treatment, limitations of the types of services that can be provided in each setting that can influence the type and level of treatment for individuals with co-occurring disorders, and competition for funding may cause problems between the fields rather than cooperation.

Can Patients Cause Ping Pong Treatment to Happen?

People may be unaware of the need to make certain changes. Others may know that something is wrong with their lives and that what they are doing is not working. Even when a person knows there is a problem, they may not know what to do about it. That is why there are treatment facilities. In the same manner that people should not treat their own diabetes or heart disease, they should not treat their own psychiatric or addictive disorder.

It is difficult enough to acknowledge and aim for recovery from one disorder, much less two or even more. If a person does not like or accept a diagnosis or does not think their symptoms are the result of a mental health illness or a substance use disorder, they may “ping-pong” themselves between treatment providers looking for a different diagnosis or treatment focus.

Even in treatment, a person may find they don’t want to talk about whichever disorder the clinician or therapist wants to address. This is often referred to as, “I have the other disorder.” In other words, a person may say, “Hey, I didn’t come here to talk about mental health. I have a problem with alcohol and drugs.” Another person may say, “Wait a minute, I didn’t come here to talk about drugs and alcohol. I’m here because of a mental health problem.” These reactions are just human nature when faced with an unwanted diagnosis. Most of these comments come from fear and a lack of information.

People who enter treatment because of problems with alcohol and drugs may be uncomfortable talking about psychiatric disorders because it comes too close to one of their greatest fears. The fear that underneath the alcohol and drugs is “insanity.” Why else would they have done some of the things they have done and felt some of the feelings they have felt?

People referred to treatment for a psychiatric disorder may be uncomfortable talking about alcohol and drugs. They may have felt alcohol and drug abuse is the only thing that makes their symptoms bearable. The thoughts of trying to manage depression, anxiety, or thought disorders without the use of their drug of abuse may sound like a fearful intolerable idea.

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What Is the Solution?

The solution is still dual recovery. The “insanity” of addiction can only be resolved through working toward abstinence. A psychiatric disorder can only be managed without the interference of alcohol and drug abuse. In other words, addressing both substance abuse and mental health symptoms at the same time makes recovery from either disorder possible. Separate systems would work well for both psychiatric and substance disorders if these disorders were not inter-linked. However, since these disorders are inter-linked, obviously there had to be a better way to treat people with medical disorders of the brain.

In the past few years there have been significant advances in treating people who are diagnosed with co-occurring disorders. The integrated treatment approach provides a doable solution and is the preferred approach among those experienced in treating the dually-diagnosed. If there is going to be true change in either system, there must be a combined effort of mental health treatment and substance abuse treatment in order to address the needs of the person seeking treatment and provide holistic care. As technology and the world evolves there must be a match for services for those who evolve with it.

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