title: Barriers to serving clients with co-occurring disorders in a transformed mental health system.
abstract: OBJECTIVE
  The publication of the President's New Freedom Commission Report in 2003 led to hope and anticipation that system transformation would address barriers that have impeded the delivery of integrated services for clients with co-occurring mental health and substance use disorders. Have problems been resolved? This study analyzed providers' perspectives on serving clients with co-occurring disorders in a large mental health system that has undergone transformation.
  
  
  METHODS
  Six focus groups were conducted with providers at specialty mental health treatment organizations that received funding to transform services. Using content analysis, the authors identified major themes of the focus group discussions.
  
  
  RESULTS
  Participants reported several barriers within the mental health system and challenges associated with collaborating with specialty substance abuse treatment providers that impede the delivery of integrated care.
  
  
  CONCLUSIONS
  In spite of efforts to improve co-occurring disorder service delivery in a transformed mental health system, barriers that have historically impeded integrated treatment persist.
authors: Dr. Padwa and Dr. Braslow are with the Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles (e-mail: hpadwa@ucla.edu ). Dr. Guerrero and Ms. Fenwick are with the School of Social Work, University of Southern California, Los Angeles.
authors: Howard
authors: H
authors: Padwa
authors: Erick G
authors: EG
authors: Guerrero
authors: Joel T
authors: JT
authors: Braslow
authors: Karissa M
authors: KM
authors: Fenwick
mesh_terms: D019033:Delivery of Health Care, Integrated / Q000458:organization & administration / Q000706:statistics & numerical data; D017144:Focus Groups; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D015141:Los Angeles; D001523:Mental Disorders / Q000150:complications* / Q000628:therapy*; D008605:Mental Health Services / Q000458:organization & administration / Q000706:statistics & numerical data*; D019966:Substance-Related Disorders / Q000150:complications* / Q000628:therapy*