TDMHDD Office of Special Populations
and Minority Services

Co-Occurring Disorders (COD)

The Tennessee Department of Mental Health and Developmental Disabilities (DMHDD) uses the term co-occurring disorders to describe a person or service recipient as having a brain illness of at least one mental disorder, along with an alcohol and/or drug abuse/dependence disorder. The term co-occurring disorders is often used interchangeably with the term dual diagnosis, co-morbidity, concurrent disorders, and double trouble. “co-occurring disorders” is becoming the prevalent term and is therefore the “term of choice” for TDMHDD.

People or service recipients with combined mental illness (depression, bipolar disorder, anxiety disorder, psychotic disorder, etc.) and substance use (alcohol and drug) diagnoses are a fast growing segment of residents in our communities. Co-occurring disorders are more common than one might think, and according to the State of Tennessee Co-occurrence Task Force, “The Next Step” (2002):

• SAMHSA’s 1998 statistics sourcebook estimated 20 million people have some type of substance use disorder in a given year, 8 million people of whom will also have a co-occurring mental health disorder. This comprises 4.7% of the age 15-54 population of the U.S. Of those with a substance use disorder during a given year, 42 percent also have a mental health diagnosis (52 percent lifetime);
• According to the National Comorbidity Study (1991), 56% of all persons aged 15-54 years with a mental or addictive disorder have at least one other co-occurring disorder (Kissler, 1994);
• Adolescents with serious emotional problems are nearly four times more likely to be dependent on alcohol and/or drugs than adolescents with low levels of emotional problems.

Increasingly, the nation and the State of Tennessee is recognizing that existing systems of care designed to treat people or service recipients with single diagnoses are less effective for people or service recipients with co-occurring disorders. So in an effort to address this issue, TDMHDD is active in developing strategies to better serve the co-occurring disorders person/or service recipient in Tennessee. TDMHDD has statewide, regional and local contracts with providers to:

• Educate professionals about co-occurring disorders and the need for integrated services;
• Inform the public about co-occurring disorders and how to access services;
• Develop more integrated treatment services for co-occurring disorder service recipients and their families;
• Provide case management services to co-occurring disorders service recipients who do not have insurance nor an ability to pay.

For more information about co-occurring disorders please contact Ken Horvath in the Tennessee Department on Mental Health and Developmental Disabilities (TDMHDD) Office of Special Populations and Minority Services.