Co-Producing Solutions: How Diverse Perspectives Shape Integrated Concurrent Disorder Care

Background: Healthcare for people with co-occurring mental health and substance use disorders (i.e., concurrent disorders) has been described as fragmented and uncoordinated in Canada. Despite evidence that integrated care is associated with improved health and social outcomes, siloed health services continue to dominate the health system. Absent from the discourse around meaningful system improvements are the perspectives of people with lived/living experiences and healthcare professionals. This presentation describes the healthcare experiences of individuals with concurrent disorders, as well as the perspectives of healthcare providers, and identifies recommendations for policy and practice improvements to address barriers and promote care integration.

 

Approach: A modified online e-Delphi study was conducted to reach consensus on the most important elements of integrated and recovery-oriented care for people with concurrent disorders. Data were collected between May 2022 and June 2023 across three iterative rounds. This analysis focuses on qualitative responses from Round 2, where participants (N=13) responded to open-ended questions about current challenges in mental health and substance use care. Data were coded and analyzed using an inductive, reflexive thematic approach.

 

 

Results: Four main themes were identified within existing mental health and substance use care: high-barrier services, lack of integration, need for person-centred care, and the importance of prioritizing the voices of people with lived/living experience of concurrent disorders. Recommendations for change have been identified for each theme and represented across micro, meso, and macro levels.

 

Implications: This research identifies structural and systemic issues in concurrent disorder care and the recommended changes. Recommendations at all levels emphasize the need for greater integration and continuity of care, with holistic and person-centred approaches as foundational principles. Furthermore, findings underscore the need to address upstream opportunities and system-level barriers. As the demand for concurrent disorder care continues to grow, these findings are essential for informing clinical best practices, health system improvements, and policy development.