It’s not often that I let my opinions out freely rather than letting the data do the talking, but this issue’s been making me mad for a while and now it just has to come out. As part of our work on the A3 rehab-finder we’ve been trying to get some measure of standardization into the system so that when we match those looking for treatment with provides we get a good fit. The problem is that when SAMHSA collects this data there is essentially no oversight whatsoever regarding the services addiction treatment providers report and their actual capabilities for providing those services.
One of the most obvious examples of this has to do with providing services for clients who suffer from both mental health issues and drug and/or alcohol problems. This happens often and SAMHSA has a few specific fields that ask providers if they can handle these more difficult cases. Over 50% of addiction treatment providers claim they can, but since no one ever checks up on them, it’s just their word we’re supposed to count on. Well, as far as at least some of them are concerned, having a psychiatrist come by once a month for a few hours is enough, still other providers offer even less in terms of mental health provisions. Believe it or not, some who claim to offer mental health services do not allow the use of any psychiatric medication… I think that actually qualifies as negligence.
There is some research looking into this sort of stuff, including work from Dartmouth (and Dr. Mark McGovern) using an instrument called the DDCAT (Dual Diagnosis Capacity in Addiction Treatment). Unfortunately, as usual, the findings aren’t making it into the actual field. I think it’s due time that we hold providers accountable and set some sort of standard for each of these services that they claim to provide.
I mean seriously, could you imagine gynecologists being able to provide post-mortem examinations without training? Oh, I guess that’s happening too… Nevermind.