title: Beyond the limitations of best practices: how logic analysis helped reinterpret dual diagnosis guidelines.
abstract: The co-occurrence of mental health and substance use disorders is becoming increasingly recognized as a single problem, and professionals recognize that both should be addressed at the same time. Medical best practices recommend integrated treatment. However, criticisms have arisen, particularly concerning the difficulty of implementing integrated teams in specific health-care contexts and the appropriateness of the proposed model for certain populations. Using logic analysis, we identify the key clinical and organizational factors that contribute to successful implementation. Building on both the professional and organizational literatures on integrated services, we propose a conceptual model that makes it possible to analyze integration processes and places integrated treatment within an interpretative framework. Using this model, it becomes possible to identify key factors necessary to support service integration, and suggest new models of practice adapted to particular contexts.
authors: Département d'administration de la santé, Groupe de recherche interdisciplinaire en santé, Université de Montréal, Pavillon 1420, boul. du Mont-Royal, Montréal, Québec, Canada H2V 4P3. astrid.brousselle@umontreal.ca
authors: Astrid
authors: A
authors: Brousselle
authors: Lise
authors: L
authors: Lamothe
authors: Céline
authors: C
authors: Mercier
authors: Michel
authors: M
authors: Perreault
mesh_terms: D019985:Benchmarking; D019033:Delivery of Health Care, Integrated / Q000458:organization & administration*; D017831:Diagnosis, Dual (Psychiatry); D005260:Female; D006801:Humans; D008128:Logic; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D008605:Mental Health Services / Q000458:organization & administration*; D017146:Models, Organizational; D009096:Multi-Institutional Systems / Q000458:organization & administration; D010043:Outcome and Process Assessment, Health Care; D010348:Patient Care Team / Q000458:organization & administration*; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*
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