Dual Diagnosis Capability

There are two resources available to help service organizations assess their capability (or capacity) to provide treatment to people diagnosed with co-occurring substance use disorders and mental disorders and to develop and implement a plan to do so with increasing capacity over time. These tools are known as the following:

• Dual Diagnosis Capability in Addiction Treatment (DDCAT) Index
• Dual Diagnosis Capability in Mental-Health Treatment (DDCMHT) Index

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STRUCTURE

The DDCAT and DDCMHT indexes are comprised of 35 items that explore an organization's policies, clinical practices, and workforce capacities (e.g., staff education, training, licensure, experience, availability). These items are organized into seven domains that include the following:

• Program structure
• Program milieu
• Clinical practice/assessment
• Clinical practice/treatment
• Continuity of care
• Staffing
• Training

(For more details, consult "Resources" below.)

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PROCESS

Service organizations interested in an assessment of their dual-diagnosis capabilities collaborate with program consultants, evaluators, and other providers of technical assistance, who use the DDCAT and DDCMHT indexes to gather data during site visits.

Service organizations interested in an assessment of their dual-diagnosis capabilities collaborate with program consultants, evaluators, or other providers of technical assistance who are external to their organizations. The consultants use the DDCAT and DDCMHT indexes to gather data during site visits, using the following methods:

• Observations of service-team meetings, administrative meetings, clinical interactions
• Interviews with administrators, program managers, team leaders, direct-service providers, consumers
• Reviews of materials, such as organization policy manuals, clinical charts, educational materials for consumers

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A CONTINUUM OF CAPABILITY

Consultants review and score the data they have collected with the indexes and categorize the organization along a continuum of capability.

The continuum for addiction-service organizations assessed with the DDCAT index includes:

• Addiction-only services (AOS)
• Dual-diagnosis capable (DDC)
• Dual-diagnosis enhanced (DDE)

The continuum for mental-health service organizations assessed with the DDCMHT index includes:

• Mental-health-only services (MHOS)
• Dual-diagnosis capable (DDC)
• Dual-diagnosis enhanced (DDE)

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PLANNING & ORGANIZATIONAL CHANGE

Program consultants, evaluators, and other providers of technical assistance help leadership teams at organizations develop and implement a plan to enhance their capabilities to provide services for co-occurring disorders and to maintain those advancements over time.

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RESEARCH & DEVELOPMENT

DDCAT was developed by the Dartmouth Psychiatric Research Center of Dartmouth Medical School in Lebanon, New Hampshire, with funding from Robert Wood Johnson Foundation's Substance Abuse Policy Research Program and from SAMHSA's Co-Occurring State Incentive Grants (COSIG). The index was developed and tested in community addiction-treatment programs. Psychometric studies have also been conducted. Current research is focused on the following:

• Refining the instrument for content, scoring, and interpretation
• Linking DDCAT scores with patient- and program-level outcomes
• Adapting the index for mental-health service organizations (e.g., DDCMHT)

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RELATED RESOURCES

• Dual Diagnosis Capability in Addiction Treatment (DDCAT) Index

• Dual Diagnosis Capability in Addiction Treatment (DDCAT) Toolkit

• Dual Diagnosis Capability in Mental-Health Treatment (DDCMHT) Index

• Dual Diagnosis Capability in Mental-Health Treatment (DDCMHT) Toolkit

• Assessing the Dual Diagnosis Capability of Addiction Treatment Services, Journal of Dual Diagnosis.