I would not want the accomplishment to be diminished. Cast appropriately as a contribution to republican inquiry where politics is "responsive to our highest aspirations rather than merely acting as a check on our basest motivations", Soni explained like no other what has happened to the once-central concern for "public happiness," which might still register as a value, but has no institutional support like the welfare state that demands some concrete commitment to the happiness of others. No mere retreat to primordial self-interest, the poverty of our public commitments have a long and important history we can now better understand as it is tied, surprisingly, to the fate of a trivial concern. (p. 82)
After 20 years of development and research, dual diagnosis services for clients with severe mental illness are emerging as an evidence-based practice. Effective dual diagnosis programs combine mental health and substance abuse interventions that are tailored for the complex needs of clients with comorbid disorders. The authors describe the critical components of effective programs, which include a comprehensive, long-term, staged approach to recovery; assertive outreach; motivational interventions; provision of help to clients in acquiring skills and supports to manage both illnesses and to pursue functional goals; and cultural sensitivity and competence. Many state mental health systems are implementing dual diagnosis services, but high-quality services are rare. The authors provide an overview of the numerous barriers to implementation and describe implementation strategies to overcome the barriers. Current approaches to implementing dual diagnosis programs involve organizational and financing changes at the policy level, clarity of program mission with structural changes to support dual diagnosis services, training and supervision for clinicians, and dissemination of accurate information to consumers and families to support understanding, demand, and advocacy. (p. 26)
Severe Mental Illness in Primary Care by Rusello
