BEST PRACTICES What Is Integration? Part I

Increased recognition of the importance of providing appropriate services to individuals and families with co-occurring mental health and substance use disorders has led to widespread recommendations to promote “integration” of mental health and substance abuse systems, services, and treatment as a mechanism to achieve this goal. While this is a logical recommendation, and one that is generally supported by an increasing volume of research (cf SAMHSA’s Integrated Dual Disorder Treatment Toolkit (ref) and Treatment Improvement Protocol #42 on Substance Abuse Treatment for Individuals with Co-occurring Disorders (ref)), the use of the term “integration” is often associated with lack of precision regarding the meaning of the concept, and in an area already associated with considerable conceptual difficulty, this lack of precision may result in further confusion. This issue was raised in the previous edition of this column, and was deferred to this edition for further discussion. One source of confusion is that the term “integration” may vary with reference to what is being “integrated.” For example, integration may be