Implementing Integrated Systems of Care for Individuals and Families with Complex Needs

Challenge: Individuals and families with co-occurring mental health and substance use conditions - along with other complex health and human service needs are an expectation – not an exception – in all settings and systems, associated with poorer outcomes and higher costs in multiple domains. If our job is to design our systems within available resources to be better matched to the needs and hopes of the people coming for help, then individuals and families with multiple and complex challenges should clearly be welcomed and served as a priority for care. Unfortunately, the opposite tends to be the case, and these individuals are often experienced as misfits at the system level, program level, and clinical practice and competency level. We need to do a better job.

Position:

We have enough available knowledge about how to provide “co-occurring/complexity capable” integrated services to individuals and families with complex needs, and how to change practice and programs to implement what we know. Co-occurring or complexity capability means that each program and each person providing care is organized within existing mission, job, and resources to routinely provide appropriately matched integrated interventions for multiple issues to the people with complex needs currently being served.

• All systems must engage in organized performance improvement activities so that all programs and services are designed to welcome and provide co-occurring/complexity capable integrated services to people with complex needs.

• All programs must become welcoming, person/family-centered, hopeful/strength-based (recovery or resiliency oriented), trauma informed, and co-occurring or complexity capable.

• All persons providing services must become welcoming, person/family-centered, recovery/resiliency oriented, trauma informed, and complexity competent as well. AACP recognizes that there are available principles, practices, and processes for making progress toward this goal, in particular the Comprehensive Continuous Integrated System of Care (CCISC).

Please reference the attached position paper for more information about implementation.

This position statement and position paper replace archived “Program Competencies in a Comprehensive, Continuous, Integrated System of Care for Individuals with Co-occurring Psychiatric and Substance Disorders” (2001)